A Comparison of Seven Family Therapy Approaches

Dimensions which should be part of a family theory are developed by drawing from ‘Integrative Family Therapy’, a theory incorporating the concepts, hypotheses, and techniques of American family therapists. The family theories of seven family therapists (Minuchin, Haley, Zuk, Friedman, Speck, Boszormenyi-Nagy, Rubinstein) are described and compared with one another. Their limitations are shown and thereby the characteristics of approaches of family therapy are indicated. Their contribution to a more encompassing ‘Integrative Family Theory’ is shown.     

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.     

Guidance,counselling, therapy: responses to ‘marital problems’ 1950–901

This paper makes a contribution to the still relatively undeveloped literature on the sociology of counselling, using a detailed case study of one organisation. Styles of intervention are explored in the work of the National Marriage Guidance Council/Relate. The paper rejects a simple linear development model based on transitions from ‘guidance’, to ‘counselling’ to ‘therapy’ Influences deriving from Rogerian models of counselling, from psychodynamic and behavioural theory are explored and are placed in the context of wider organisational factors. Attention is given to the varying fortunes of the medical model within Marriage Guidance. The paper concludes with an examination of the contradictions thrown up by recent attempts to develop an eclectic model of marital counselling, which appear to founder on the absence of any clearly defined goals for intervention.     

Stages of Change Theory in Family Therapy for Sibling Sexual Assault

Family therapy understands the benefits of therapeutically supported dialogue amongst family members when there are challenging themes and topics that need to be discussed. This paper is an attempt to explore ways that family therapists can work with family members who are thrust into therapy rather than ‘voluntarily’ signing up for it. It applies ideas from the drug and alcohol field such as Stages of Change theory and Motivational Interviewing. The paper explores how these ideas and approaches might help family therapists to formulate a concept of resistance and to make helpful dialogue more likely. They are applied to families experiencing sibling sexual assault, where they become involved with a legal response that necessitates a therapeutic intervention.     

‘Family ideology’: identification and exploration

The issue of ‘family ideology’ has been systematically ignored by a majority of ‘family¹ scholars whilst it has been taken for granted by a minority. The following study arises from the author's attempts to explore the issue of alternative theoretical approaches to the analysis of family life’.² Increasing numbers of contemporary researchers concur in recognising the diversity of ‘family forms’ and the inappropriateness of speaking of ‘The Family’.³ Despite these recognitions many researchers find themselves re-adopting the term ‘The Family’ in their discussions and especially in the titles of their work. For example. Segal clearly recognises that the ‘traditional family model’ no longer reflects the reality of our lives (1983, 11) and yet the title of her book is What is to he done about THE FAMILY? (emphasis added). One reason for the re-importation of the idea of ‘The Family’ may be found in the rather limited nature of previous conceptualisations of ‘family ideology’. With the exception of Barrett (1980), recognitions of ‘family ideology’ tend to be conceptualised in terms of sets of partisan beliefs supporting a particular ‘family form’. Thus the concept of ‘The Family’ is rarely regarded as being problematic in itself, rather attention is paid to the presumed virtues or deficiencies of the particular form of ‘The Family’ which is assumed to be prevalent. Notwithstanding the recognition of ‘family diversity’ or the inappropriateness of the term ‘The Family’, nearly all discussion becomes a straightforward attack upon, or defence of. ‘The Family’.⁴ Only very rarely does analysis avoid this trap and question whether ‘The Family’ really exists to be attacked or defended; thus Collier et al. have asked ‘Is there a Family?’ (1982) and the present author has asked ‘Do we really know what “The Family” is?’(Bernardes, 1948a). The objective here is to identify and explore a specific conceptualisation of ‘family ideology’. The aim is to avoid engaging in attacks upon, or defences of, ‘The Family’ but rather to address the ideological context of such debates themselves, especially in respect of the assumed existence of ‘The Family’. It is hoped that this approach will stimulate a much more critical examination of ‘family ideology’ and the concept of ‘The Family’. More generally, the attempt to conceptualise ‘family ideology’ in this much broader sense is seen as a pre-requisite for the development of an alternative theoretical approach to the analysis of ‘family life’.     

Family Therapy's Coming of Age: Less Haste,More Speed

Responding to the question implicit in the title of the 1985 National Family Therapy Conference ‘Coming of Age’, the author argues that Australian family therapy still has a number of issues to face before it can be said to be a mature and independent adult. The paper focuses on three issues — ideology in family therapy, theory for practice, and practice itself— and raises questions about the adequacy of Australian family therapy's theoretical maturity, suggesting that there is still too much reliance on the ‘new’ and on the ‘guru’ rather than on a solid building on therapeutic experience.     

Family Constellation — A Therapy Beyond Words

Family Constellation, a psychotherapeutic approach associated with the name Bert Hellinger, has become a popular yet also controversial form of systemic therapy in the German‐speaking therapy community. ‘Family Constellation’ (Familienstellen) means the individual client's physical‐emotional positioning and re‐positioning of substitute family members in relation to each other, with help of a therapeutic group. Family Constellation is a one‐session approach that addresses family‐of‐origin issues. The therapeutic process is highly experiential, utilising multiple sensory modalities. Hellinger locates his model within phenomenology, and his practice has roots in several therapy schools. His model offers complementary therapeutic techniques in our ‘languaged’ world of family therapy.     

Family Theory According to the Cambridge Model

The family systems theory of David Kantor and William Lehr as expressed in their book, Inside the Family, forms the foundation for the model of family therapy which is taught at the Family Institute of Cambridge. This paper is a summary of and an introduction to that theory. Their concepts of family boundaries, dimensions, typal arrangements, and the four player system are presented and discussed.     

A Systems-Crisis Approach to Family Treatment

This paper presents a model which integrates a wide range of possible interventions using family treatment and provides a method of differential decision making with regard to the intervention to be used in a given case. The model uses an ecological perspective and draws on concepts from general systems theory and crisis theory. A number of case examples are provided to demonstrate how the model has been applied in a clinical setting.     

A family-based, developmental-ecological preventive intervention for high-risk adolescents

Family-based preventive intervention has emerged as a promising modality for preventing antisocial behavior problems in youth. This article introduces an intensive, family-based preventive intervention for high-risk adolescents: Multidimensional Family Prevention. Multidimensional Family Prevention combines the advantages of standard prevention models (curriculum based and protection focused) with those of psychosocial treatment models (assessment based and problem focused). The model's main features are described: theoretical foundations (risk and protection theory, developmental psychopathology, ecological theory), guidelines for constructing a multidomain prevention program (family and peer relationships, school and prosocial activities, drug use and health issues, cultural themes), and strategies for tailoring and implementing five flexible intervention modules (adolescent, parent, interactional, extended family, extrafamilial). Implemented in the family's home, the intervention works to create a resilient family environment that supports the basic adolescent developmental goals of renegotiated attachment bonds within the family and durable connections with prosocial institutions.     

Attachment and Divorce

In this paper, recent efforts to integrate attachment theory and family systems theory are reviewed and extended to the context of therapy with families coping with the divorce process. Family members' global working models of attachment, rather than the spousal attachment alone, are proposed as the point of intervention, with the goal of helping families reestablish an "attachment equilibrium" during and after divorce, thus addressing potentially problematic expressions of attachment behavior that could interfere with resolution of the divorce, causing difficulties in future co-parenting and other family functioning.     

Family Therapy: Out from Behind the Hero Narrative

Schools of family therapy have been highly selective in their presentation of the theory/practice nexus. Family therapy's method of teaching (the infamous workshop format) has hampered it's growth as a practice and academic discipline. An inadvertent, unhelpful legacy of Gregory Bateson has been that lesser scholars have aped his capacity to draw on other fields of knowledge without his rigour, or his propriety. Family therapy's cavalier dealings with bodies of knowledge and its reliance on miraculous case studies has resulted in the bypassing of individual suffering. The heroic narrative that has dominated family therapy has precluded other styles of stories for therapists, theorists and clients. Family therapy has been dominated by the myth of the hero, with its accompanying motif of the puer eternus (the eternal youth). Family therapy has been forever reinventing itself, forever the ‘new kid on the block’. This fascination with newness has interfered with family therapy's capacity, at times, to consolidate its genuine value as a therapeutic entity.     

THE FAMILY CRISIS INTERVENTION LITERATURE: WHAT IS MEANT BY “FAMILY”?*

Family crisis intervention is a rapidly growing area of clinical care in family therapy which lacks clear conceptualization, especially with respect to how “family” fits into crisis intervention theory. This paper integrates recent concepts from the family therapy literature into three views: family as background, family as context, and family as a unit. The family crisis intervention literature (56 publications) is reviewed and categorized according to these three views. Clarity in how “family” is viewed and consistency between theory and practice are examined. Recommendations for improving the conceptualization of “family” in family crisis intervention theory and practice are made.     

The Family Movement,Bowen Theory,and Theoretical Medicine: A View from the 21st Century

Important changes have occurred in the family movement in the United States since it emerged in the mid‐1950s. Psychiatry supported the movement in its early years, but that changed as psychiatry abandoned the biopsychosocial model and adopted the biological paradigm through the 1970s. This development pushed family and other therapies to the periphery of the discipline. Medicine is dominated by the biological paradigm and cause‐and‐effect thinking. The roots of the medical model go back to Pasteur. In contrast, psychiatry in the United States had been dominated through the 20^th century by psychoanalytic thinking, which rendered the discipline a step‐child to medicine. This and other factors pushed psychiatry to get biological. The change generated a ‘failure of nerve’ in the family movement, abandoning the role of the family in schizophrenia in the face of psychiatry's assertion that all serious mental illnesses had nothing to do with the family. Other important changes separating the family movement from psychiatry occurred as well. Bowen theory is anchored in biology and evolution, but it is not a biological paradigm. Maintaining solid connections to the scientific disciplines are important for keeping the theory an open system. The recent emergence of systems biology and systems medicine could challenge psychiatry's allegiance to the biological paradigm and bring family systems theory centre stage in the discipline. These new disciplines may also arrive at a systems theory of the individual that can be integrated with family theory, powering a paradigm shift in medicine as a whole.     

Family Intervention and Health Care Costs for Kansas Medicaid Patients with Schizophrenia

Despite a number of studies investigating the effect of pharmacotherapy on treatment costs for schizophrenia patients, there has been little attention given to the effect of family intervention. In this study, data from the Kansas Medicaid system were used to analyze healthcare costs for 164 schizophrenia patients who had participated in family intervention. Structural equation modeling was used to test two competing views of the role of family intervention in treatment. The results showed that a model including direct and indirect effects of family intervention provided a better fit to the data. Family intervention had a significant indirect effect on general medical costs (through other psychological treatment) that showed a savings of $586 for each unit increase in the provision of these services. In addition, the total indirect effects for family intervention showed a $580 savings for general medical costs and $796 for hospitalization costs (for each unit increase).     

The Centrality of the ‘Family Dispute Resolution’ Process to the Separating Family,the Community and the Administration of Justice

The International Convention on the Rights of the Child sees family as the fundamental unit of society and aims to ensure that children grow up in ‘an atmosphere of happiness, love and understanding.’ Incorporated as an object of the Family Law Act 1975, the Convention guides the outcomes and informs the way that the Family Law Act should be interpreted and applied. Wherever possible, adherence to the Convention requires not litigation, adversarial contest, and determinative processes, but facilitative dispute management and dispute resolution processes. This is because ‘happiness, love and understanding’ can only be provided by parents and by families themselves – not by a court. In this address I examine the extent to which the family law system supports facilitative processes in general and family dispute resolution (FDR) in particular. I consider the tensions between legal processes and self‐determination and outline a series of benefits that derive from the default use of FDR processes.