Beginning Struggles with Families*

Beginning treatment with families is marked by a sense of struggle between the family and the therapist. The family is seen as testing the therapist and as asking through their behavior questions about the therapeutic process. The therapist is advised to focus intently on the beginning interviews, working toward the point where the family relaxes and decides on an intuitive level to enter therapy. The major hurdle is in dealing with the family's anxiety as the therapist attempts to shift the focus from the individual patient to the family as a whole. Strategy in establishing this shift is outlined     

Multiple Family Therapy Systems

This paper investigates multiple family therapy (MFT), a treatment method which includes several families in a series of sessions with the therapist(s). A brief historical development of MFT is included as well as reports of multiple family therapy groups found in the literature. The characteristics of this treatment method are delineated with special attention to the elements of change attributed to MFT and the stages of development in MFT groups. The role of the therapist and special problems in MFT are also explored. Some implications for research are outlined, indicating that MFT is lacking adequate validation as a treatment modality. Possible advantages inherent in multiple family therapy systems, which have been suggested by therapists' clinical findings, are also reported.     

Family Work and Acquired Brain Damage

Acquired Brain Damage (ABD) causes immense difficulties for individuals and families and is increasingly recognised as a serious community issue. This paper focuses on the burden placed on family members with a head injured relative. The authors propose that when working with families with a member with a neuropsychological condition, the family therapist may be required to embrace a more flexible role. Depending on the developmental needs of the family, the family therapist may at times: provide educational information about brain damage and its effects arrange family support groups or wider network meetings be the family's advocate in the context of complex legal and financial bureaucracies or undertake marital, sexual or family therapy when required. Whatever the role played, a ‘family sensitive practice’ approach by family therapists is advocated. It is also deemed useful to develop a theoretical assessment model which helps the therapist locate where individual family members are in their negotiation of the tasks of grieving, restructuring, identity reformation and achieving a sense of growth after head injury. Further implications for clinical practice are outlined.     

Family therapy: An orientation

Conclusion The family therapist is an active, involved therapist. He must be emotionally lithe and resilient, prepared to deal with, or deal out, the unexpected. His challenge is to learn to use his own impulses and reactions in a way that the family can use to understand themselves better. He makes use also of any people and resources in the family's environment which might be of help to them. There are some basic techniques and orienting principles available to the family therapist, and it is these which it has been the task of this paper to set forth. Beyond these, the responsibility rests with each family therapist to comprehend himself and his place in his own family, and then to use his creativity to transform what he knows and what he feels into a form which can be used by the families he treats in their development.     

Towards a Multicultural Society: Family Therapy with Greek Families†

Language and cultural differences can pose barriers to effective intervention in migrant families in conflict. Family therapy approaches can provide some useful strategies for overcoming these obstacles. A family therapy approach can (1) emphasise the value of utilizing natural network support systems; (2) provide a model which helps clarify communication problems arising in the relay of information through a third person acting as an interpreter; (3) underline the importance of non-verbal and process aspects of family communication; (4) suggest techniques for negotiating, joining, and finding commonalities of family experience between a therapist and family of different ethnic background. The therapist needs to develop sensitivity to both the universal and specific ethno-cultural structures, norms and problems of families; when this sensitivity is achieved powerful and culturally syntonic healing forces can be released. Examples of successful family therapy interventions in some Greek families in conflict are given.     

Therapist abandonment experience in work with families disrupted by protective intervention

The experience of abandonment is central and pervasive for therapists and other professionals involved in work with families disrupted by protective intervention. Abandonment experience is not unique to the protective service situation, nor is it the only important experience in work with disrupted families. However, a combination of factors operate in that situation to activate and emphasize the experience of abandonment in the therapist.This clinical discussion summarizes relevant theory, and identifies factors in the situation which contribute to therapist abandonment experience. It describes and illustrates therapist abandonment experiences in the course of work with a disrupted family, and discusses the impact of these experiences on therapeutic work.He is also in Private practice.     

MODES OF EXPRESSION IN FAMILY THERAPY: A PROCESS STUDY OF ROLES AND GENDER*

Twenty-two two-parent families with a referred adolescent were seen by 11 male and 11 female trainees in family therapy. Mothers, fathers, adolescents, and therapists were rated for verbal expression in affective, behavioral, and cognitive! attributional modes during the first session. Results clearly point to role and content difference in modes of expression. Of particular importance are differences by role which occured as a function of therapist gender. These differences suggest that therapist gender has an impact on family therapists' and family members' verbalizations in first sessions of family therapy.     

The South African Family in Transition: Training and Therapeutic Implications

A universal pattern of transition from the extended family to the nuclear family and beyond is proposed. Stages of transition concurrently found among South African families are detailed and examples of resultant pathology are presented. Emphasis is given to specific therapeutic dilemmas facing the South African family therapist. These include the feasibility of intervention in the extended family, the problems associated with intervention across cultural boundaries and the appropriateness of specific therapeutic goals. The current status of training is outlined and the prerequisites for effective service and training are highlighted.     

Thinking About the Emotional Interaction of Therapist and Family

The emotional interaction of therapist and family has been difficult to explore within the field of systemic family therapy. This paper looks at ways of thinking about this process. As a starting point, I take some feelings I had with three families in the course of therapy. These are used to illustrate some concepts from analytic therapy which address the emotional interaction of therapist and family. The kind of theoretical space and guidance offered within systemic family therapy is then explored, and it seems that the Milan frame gives some space for thinking about the process but offers little guidance as to exactly how this might be done. This is a paper about practice, though it's primarily a theoretical discussion. There is no aim of establishing a ‘correct’ way of understanding the emotional interaction of therapist and family.     

Does the Therapeutic Relationship Matter? A Follow-up Study of Adherence and Improvement in Family Therapy

A follow-up study of 83 families treated by family therapy at a child guidance clinic was conducted and the relation of client/therapist interaction to (i) drop out from therapy and (ii) improvement was examined. Early terminators were found to differ significantly from continuers as to their ratings of their relationship with the therapist, and trends were found for therapists' feelings to be associated with adherence to therapy. Early terminators were not distinguished by diagnosis, severity of case, or improvement rating. Improvement, on the other hand, was not associated with therapists' or clients' attitudes to each other. It is suggested that these factors are of greater significance in “joining” therapy than in its course.     

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.     

The Go-Between — Strategic Therapy with Teenagers in Separated Families*

The adolescent's experience of divorce needs to be understood within a developmental and systemic framework. Problematic or symptomatic behaviour in teenagers from separated families often reflects on the family's difficulty in managing the transition to a new and different family organisation. The type of problem or symptom presented is shaped partly by the developmental characteristics of the adolescent period, as well as being indicative of unresolved problems within the broader family system. Problem resolution can often require the involvement of both separated parents and their children in a conjoint interview, in which case a strategic family therapy approach can be particularly useful. A strategic approach offers the therapist clear guidelines regarding the focus and process of the interview, and assists the therapist to be in charge whilst remaining neutral in the sense of not allying more with one side or another. Case illustrations are included of a strategic approach with teenagers and their separated families.     

Prescribing the Families Own Dysfunctional Rules as a Therapeutic Strategy*

The use of paradox-strategy in therapy is motivated by the fact that many families request help but at the same time seem to reject all offers of help. The therapist may be drawn into a game in which every effort on his part to act as an agent of change is nullified by the family group. In systemic terms these contradictory attitudes derive from the dynamic equilibrium existing between the tendency toward change, which is implicit in the request for help at one level, and the tendency toward homeostasis which at another level imposes the repetition of the family's habitual rules of interaction. The coexistence of these forces can entangle the therapist in the family's paradoxical logic of “help me to change, but without changing anything.” By accepting the contradiction facing him and by “uniting” himself with this within the family, the therapist puts himself into a position opposite to that which the family expects. His response to the family's paradoxical request is a paradox, or counterparadox, because it creates the contradictory communication typical of rigid family systems. By prescribing its own dysfunctional rules to the family, the therapist can stimulate the tendencies toward change present in the family system.     

Personal Reflections of A Family Therapist*

In this informal paper I discuss my personal evolution as a family therapist, developments in the field, the politics of a systems approach in conventional settings, resistances to family and marital therapy by other professionals, some still puzzling aspects of family therapy, whether family or marital therapy works and what do we mean by working, directions my own work has taken, some comments about the nature of family life, the satisfactions and frustrations and stresses of being a family therapist, some hidden agendas of family therapy practices, how one's own personal family relationships affect and are affected by this kind of work, the casualties among family and marital therapists, and, finally, whether family therapists should have family therapy for themselves and their own families.     

INFLUENCES ON THEf INCLUSION OF CHILDREN IN FAMILY THERAPY BRIEF REPORT

This study examined factors that influence family therapists to include children in or exclude them from therapy sessions. We hypothesized that therapist comfort, child problem type (internalizing vs. externalizing), family composition (one- vs two-parent families), and presenting problem (child-oriented problem vs. adult-oriented problem) affect therapists' inclusion of children. A survey of clinical members of AAMFT found that half of the therapists excluded children on the basis of their comfort and that those who felt more comfortable were more likely to include children in sessions. Therapists included children more frequently in cases of an internalizing vs. an externalizing child, more with single-parent than two- parent families, and more often when the presenting problem focused on a child than on an adult. Implications of the findings are discussed.     

‘Lady,Leave My Culture Out of It!’ An Interview With Nada Miocevic

Nada Miocevic is a social worker and family therapist who trained at Zagreb University in Croatia and at Melbourne University in Victoria, Australia. She completed her training in family therapy in 1975 at the Bouverie Centre, Melbourne. Since migrating to Australia in 1967, her work with migrant and refugee families has taken her throughout Australia and overseas. Currently she is in private practice. Her work involves conducting training courses in supervision and supervision of supervision, as well as her continuing work with families who experience long‐term illnesses.     

ONE PERSPECTIVE ON THE MILAN SYSTEMIC APPROACH: PART II. DESCRIPTION OF SESSION FORMAT,INTERVIEWING STYLE AND INTERVENTIONS*

The Milan method of working with families includes a number of unique innovations. Among these are a pattern of creative teamwork that clearly separates the cognitive constructions of the therapist in contrast to the belief systems of the family, a style of interviewing that releases information latent in the family, and some novel interventions that facilitate the family's capacity to discover its own non-symptomatic solutions.     

Walk-in Together: A pilot study of a walk-in online family therapy intervention

Many Australians are requiring mental health care, including families, leading to long wait times in order to access support. Walk-in therapy reduces barriers to mental health support services by providing support at the time that families seek help. This paper presents a proof-of-concept study investigating the acceptability and short-term effectiveness of an online walk-in family therapy service, Walk-in Together (WIT). Part 1 of the paper describes the experiences of 44 family members from 22 families who presented to a public family therapy clinic for a virtual walk-in family therapy session. The session was conducted by a team of three experienced family therapists. Family members' experiences were sought pre-session, post-session, and at 6 weeks follow-up via survey and interview. Part 2 of the paper explores therapist perceptions (n = 7) of the WIT approach, through thematic analysis of semi-structured interview data. Post-session feedback showed 85% of family members found WIT to be helpful and 50% were optimistic about their future as a family after their WIT session. Six weeks post-session it was revealed that WIT supported planning for families in equipping them to move forward with 88% of family members reporting that they knew what to do after the session. All therapists uniformly experienced the model as offering a timely and beneficial service, suitable for diverse presentations and constellations of families. These preliminary results suggest the significant utility of this WIT intervention as a well-received and helpful service for families, who valued the easy access and rapid therapeutic response afforded by the online, walk-in delivery model. This proof-of-concept paper suggests the potential for further development and growth of WIT, as well as other mental health support services using a walk-in, telehealth model to meet the rising demand for therapeutic support for families in distress.