ASSESSING CHANGE IN FAMILY FUNCTIONING AS A RESULT OF TREATMENT: THE STRUCTURAL FAMILY SYSTEMS RATING SCALE (SFSR)

This article describes a theoretically based structural family assessment procedure designed for use in evaluating therapy outcome. The standardized procedure for eliciting family interaction consists of the administration of three family tasks. The family's interactional patterns on the tasks are evaluated along six dimensions of structural family functioning: Structure, Flexibility, Resonance, Developmental Stage, Identified Patienthood, and Conflict Resolution. A manual has been developed for standardizing ratings for research applications. The measure demonstrated good interrater and internal consistency reliability. Available evidence for the content, factor, and construct validity of the measure is presented. Clinical outcome research studies conducted with the measure provide evidence that the measure is sensitive to different types of structural family intervention modalities and that it discriminates between a structural family intervention versus a no treatment/wait list control condition as well as between a structural family intervention versus an individual psychotherapy treatment modality. Finally, the measure has been demonstrated to be nonreactive under both treatment and wait list conditions.     

EVALUATING FAMILY THERAPY: DIVERGENT METHODS, DIVERGENT FINDINGS

This study reports on a triangulation strategy for assessing family interaction, involving family members, their therapist and coders independently viewing videotapes. Utilizing a standardized scale, the Beavers-Timberlawn Model of Family Competence, the study found weak agreement between paired assessments within the family triad, and within the therapist-coder dyad. In addition, more complex scaling techniques such as composite "family scores" or discrepancy scores between family member dyads added no predictive power. The findings suggest that a "limit of concordance" may exist when comparing varying raters' assessments of a given family, and that methodological and/or scaling strategies designed to maximize agreement may be both fruitless and diversionary.     

THE FAMILY FIRO MODEL: A MODEST PROPOSAL FOR ORGANIZING FAMILY TREATMENT

This paper presents a model for organizing family issues and family treatment. Schutz's FIRO model is offered as a framework for organizing family issues into inclusion, control and affection categories. Following Schutz's theory of group development, we propose that inclusion, control and affection constitute a logical hierarchy of core issues to be dealt with in treating multiproblem families-inclusion first, then control, and then affection (intimacy). Furthermore, we propose that the FIRO model can be used to organize theories of family therapy. We attempt to demonstrate that different family therapies are best suited for one of the three core issues of family interaction. We advocate an "intelligent eclecticism" based on the premise that when an issue is appropriately matched with a therapy, therapeutic effectiveness should be enhanced. We also discuss implications of our Family FIRO model for clinical practice.     

WHAT'S HAPPENED TO FAMILY INTERACTION RESEARCH? AN HISTORICAL ACCOUNT AND A FAMILY SYSTEMS VIEWPOINT

The origins and evolution of family interaction research are outlined in order to examine the apparent lag in the field after the initial hopes and enthusiasms of the 1960s. It is argued that family interaction research naturally drew upon the methodology of social psychology and that there was an insufficient integration of the implications of the clinical viewpoint of family systems theory into research procedure. A discussion is presented of some central concepts in scientific psychology, drawing conclusions as to how they can be broadened for the special field of family research. An experimental method for evaluating the public verifiability of complex clinical notions is described, and a number of recent investigations are scrutinized in the light of our critique. It is concluded that there are grounds for being optimistic that the gap between clinical and research thinking can be bridged, making the assessment and refinement of abstract and intricate concepts discovered in clinical procedures accessible to scientific experimentation.     

QUANTIFYING THE CLINICAL ASSESSMENT OF FAMILY HEALTH

The Family Health Scale is an instrument designed to quantify the quality of family functioning from the perspective of an external clinical observer. Rating may be based on whatever information is available on the family but, ideally, should be derived from a valid standardized method of direct observation like the Family Task Interview (Kinston and Loader, 1986). Clinical judgement must be exercised in rating, and new methods to enhance its quality have been devised. The scale may be used with nonlabelled, as well as psychiatrically labelled, families. The FHS has demonstrated consistently high inter-rater agreement, and test-retest reliability. Evidence is also offered for its validity and specificity.     

TEACHING PROFESSIONAL WRITING TO FAMILY THERAPISTS: THREE APPROACHES

The authors present three educational approaches designed to demystify the writing process and to support better writing skills among family therapists. One framework is an academic course in professional writing, another is a writing seminar for family therapy and physician trainees within a medical school setting, and the third is a 2-hour continuing education writing workshop for family therapists. Each is replicable within a variety of settings.     

A QUESTION CLASSIFICATION SCALE FOR MARRIAGE AND FAMILY THERAPY

This paper proposes a Question Classification Scale (QCS) to permit more discrimination among the types of questions used in marriage and family therapy. The data base for the QCS development consisted of 503 family therapy questions drawn from tapes of eight family therapy experts and four trainees. The QCS was designed after studying question classification systems in philosophy, linguistics, educational research, and individual and family therapy. Each therapist-initiated question is coded in four ways, yielding a simple, yet multidimensional, picture of the therapist's questioning patterns. Future research potential of the QCS is discussed.     

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.     

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 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.     

PERSONAL AUTHORITY IN THE FAMILY SYSTEM: DEVELOPMENT OF A QUESTIONNAIRE TO MEASURE PERSONAL AUTHORITY IN INTERGENERATIONAL FAMILY PROCESSES*

This paper reports a series of studies on the development of the Personal Authority in the Family System (PAFS) questionnaire. The PAFS questionnaire is designed to measure family processes based on aspects of current intergenerational family theory (Williamson, 1981, 1982b). Eight scales which measure concepts such as differentiation/fusion, intimacy/isolation, and personal authority/intimidation in the three-generational context comprise the questionnaire. Study 1 indicates that the scales have good internal consistency and good test-retest reliability. Correlations with other measures of family processes provide validity for some of the PAFS scales. Study 2 confirms the underlying factor structure of the PAFS questionnaire and supports the construct validity of the scales. Implications for intergenerational family theory and applications in research and clinical practice are discussed.     

VALUES IN CONFLICT: CHALLENGES TO FAMILY THERAPISTS' THINKING

Our familiar and comfortable family therapy theories were not designed to deal with violence and may help maintain our collective avoidance. Our formulations appear to make violence more manageable than it is and demonstrate our naivete. The limitations of therapeutic neutrality are explored as are the dangers inherent in some of our interventions. Effective amelioration of family violence requires linkages to larger systems.-Editor.     

FAMILY RESEARCH AND FAMILY THERAPY: A REUNION?*

This decade is witnessing the re-establishment of research in family therapy as an intrinsic component of the field. It is instructive to recall that family therapy actually had its most significant beginnings in the context of family research in the 1950s and that, three decades ago, family therapy and family research were fundamentally fused. In this paper, several of the most important forms of recent and current family research and family therapy research that are important to clinicians are identified, and it is suggested that this reunion of clinical and research interests signifies a new phase in the growth of the family therapy field.     

THE ROLE OF TIME FRAME IN THE ASSESSMENT OF FAMILY FUNCTIONING

The purpose of this study was to evaluate how the stated time frame of family questionnaires can influence the individual's report of family events and relationships. Three whole-family assessment procedures were administered to a large sample of intact families under two conditions—when the respondent was asked to describe his/her family "in general" and "during the past week". Major findings indicated that (a) reports of family relationships reflected the same overall evaluation regardless of time frame, (b) the number or degree of positive endorsements was greater on the "in general" than the "past week" format, and (c) the impact of time frame varied greatly as a function of instrument. Explanations and implications of these findings are discussed.     

THE STRUCTURE OF FAMILY PARADIGMS: AN ANALYTICAL MODEL OF FAMILY VARIATION

The theory of family paradigms provides an integrative framework for under-standing and systematizing the diverse ways that families organize and make sense of family life. Using formal methods of analysis based on logical and geometrical arguments, the priecise implications of models of family types can be investigated and compared. The paradigmatic framework can thus be refined and extended to form a more rigorous theoretical grounding for family typologies is explored and a miltidimensional model is derived the geometry of which is equivalent to, but more succinctly captures, the underlying structure of uariation in family para-digms. In Part II, the resulting model is interpredtd and explored in terms of implications for family theory, theory construction, and family therapy. Clarifying the basic dimensions of the paradigmatic framework also permits more precise exploration of interrelationships among related models of family types, which can be understood as reduced models derivable from the complete geometry of the paradigmatic framework.     

FAMILY THERAPY AND IDEOLOGY*

Contemporary family therapy is examined in terms of its ideological content. The adoption of cybernetics and biological systems theory to the family has led to the erroneous belief that familytherapy is exclusively concerned with natural systems, is process oriented, content relative, and above ideology. This article argues that the family and the enterprise of family therapy are social systems and under the influence of the ideology particular to a given society. The strategic family therapy treatment of a family with a drug-addicted member serves as an example to clarify the ideological themes of contemporary family therapy. These themes are: (a) family reductionism and blaming; (b) the relabeling of personal injustice into communicational terminology; (c) the assumption that the nuclear family is optimal; (d) the conceptualization of therapy as a commodity; and (e) the model of human relatedness and intimacy supported by family therapy.     

THE USE OF INTERACTIVE VIDEO TO DEMONSTRATE DIFFERENTIAL APPROACHES TO MARITAL AND FAMILY THERAPY

This article outlines the development of an interactive video system designed to demonstrate differential approaches to family therapy using identical therapy situations. The primary purpose of the project is to resolve some of the confusion many novice family therapists experience while being exposed to the numerous family therapy approaches. Technical aspects of the interactive video system are also outlined.     

BASIC FAMILY THERAPY SKILLS, IV: TRANSGENERATIONAL THEORIES OF FAMILY THERAPY

This pape focuses on the basic skills and compentencies of transgenerational approaches to family therapy, the fourth report of a program of research surveys by the Basic Family Therapy Skills Project. In the first survey, a panel of family therapy educators listed the most critical or basic skills or compentencies of beginning family therapist with a transgenerational orientation. In the third survey, self-selected respondents rated these items according to degree of importance for beginning family therapists. Rankings of the items according to mean scores of the Likert responses indicate that transgenerational family therapy skills are founded in theory and can be identified behaviorally. The most important skills are those that use the self of the therapist to understand and utilize transgenerational family therapy skills for both therapist and client. Also listed are skills that many raters deemed "generic" rather than specifically related to transgenerational family therapy. Other findings and their implications for the future training of family therapists are discusses. Although the paper is intended for family therapy educators interested in their colleagues' ideas about critical skills in trans-generational family therapy, theorists and clinicians may also find it useful.