DYSFUNCTION AND FAILURE IN OPEN FAMILY SYSTEMS: II. CLINICAL ISSUES*

The “open family” model is widely used as a point of reference for healthy family functioning, but potential dysfunctional aspects of open families are not well understood. A unified theory is used to integrate diverse typological models of families to build a composite clinical picture of the disabled open family. The disabled open family is found to be chaotically enmeshed, caught in its commitment to collective problem solving. Its need for closure, tolerance for ambiguity, and expressive communication style can lead to intensely emotional sustained conflicts. Stress-related symptoms and aggressive acting out may be manifest in individuals, especially children. Dispersal of members may ultimately be necessitated by the exhausting process. Family therapy with the open family requires special attention to its style as a family and its characteristic responses to interventions. The unified theory is shown to be useful in planning strategy and choosing techniques for treatment of open families. The treatment issues connected with the pseudo-open family, a family with open values but severely limited resources in actual operation as an open system, are also highlighted.     

Wider Perspectives in Family Mediation: An Ecosystemic Approach

All mediation processes are constrained by their theoretical frameworks. A wider ecosystemic framework extends perspectives and can open new windows on family systems, interdisciplinary connections, and links between past, present, and future that shape decisions. While showing some similarities to family therapy, ecosystemic family mediation is a discrete process with clearly defined principles and boundaries. In practice, it needs to be tailored to the needs of the particular family, with special attention to the importance of listening and talking with children who are experiencing parental separation and major changes in their lives. Family mediators help family members to manage change. Mediators need to look for change within themselves too, remaining open to new ideas and the development of their thinking and practice.     

Latent Models of Family Processes in African American Families: Relationships to Child Competence,Achievement, and Problem Behavior

This study explored the assessment of family processes for a sample of African American kindergarten children, parents, and teachers involved in the EARLY ALLIANCE prevention trial. Using modified versions of the Family Assessment Measure, the Family Adaptability and Cohesion Evaluation Scales, the Family Beliefs Inventory, and the Deviant Beliefs measure, internal consistency analyses along with exploratory and confirmatory factor analyses provided empirical support for a Cohesion factor (cohesion and communication), a Structure factor (support and organization), a Beliefs factor (on family purpose and child development), and a Deviant Beliefs factor. Regression analyses examined the relationship of these measures of family processes to child social and academic competence, problem behavior, and early reading achievement. Family Structure (support and organization) was consistently related to parent‐ and teacher‐reported competence and behavioral outcomes, providing support for this construct as an important aspect of family process. Family Cohesion and communication, along with Beliefs, were also related to youth competence and behavior. None of the family process variables added a unique contribution to the influence upon achievement for these kindergarten children beyond the role of parental education and income. This work begins to examine specific dimensions of family processes and their relationships to important adaptive and less adaptive child outcomes. Other dimensions may be identified and examined in future research with families of color.     

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.     

Family systems functioning,family health roles,and utilization of physical health services

The purpose of the study reported here is to determine the relationship between family systems functioning, family health role, and family utilization of health services. The research is based in the Circumplex Model of Marital and Family Systems (Olson, Sprenkle, & Russel, 1979). Family functioning variables include family level of cohesion, family adaptability, and family type, as measured by FACES II. Family health role (i.e., leadership role and acceptance of sick role) and utilization of health services are measured by scales of the investigator-developed Family Health Questionnaire. The sample consists of 140 parents of 70 families, composed of two parents with children under 25 years of age living at home. Analysis reveals significant relationships between the family level of adaptability and acceptance of the sick role, in conjunction with significant gender and gender interaction effects. There are no significant differences between family cohesion levels or family typologies with the health variables.Su An Arnn Phipps is an Assistant Professor at the University of Oklahoma College of Nursing Graduate Program, Tulsa, 700 N. Greenwood, Tulsa, OK 74106. Her research interests include family systems functioning and family physical health, couples' infertility experience, and fathers' role(s) in family health. She received her Ph.D. from Oklahoma State University in Family Relations and Child Development.     

Unlocking the family secret in family play therapy

Family play therapy combines play therapy with family systems therapy. When family secrets are revealed in a family setting, with play to cushion the family's anxiety, families have the opportunity to resolve long-standing intrapsychic and interpersonal difficulties that impede the psychological well-being of both children and parents. Family play therapy effectively reduces symptomatic behavior in children in an age-appropriate manner—an advantage over family therapy that may be geared to adult cognitive levels. It also gradually shifts the family to a systems perspective of its problems in a non-threatening way, thereby facilitating the child's connection to his or her primary caretakers.Ms. Eaker is a psychotherapist in private practice in Family Systems Theory, and therapist for the United Federation Teachers' Stress Management Program and various Employee Assistance Programs, and a PhD candidate.     

GROWTH BEHIND THE MIRROR:, THE FAMILY THERAPY CONSORTIUM'S GROUP PROCESS

An earlier paper (Wendorf, 1984) presented the pragmatic aspects and theoretical model of The Family Therapy Consortium, a group set up to provide supervision and continuing education in family therapy. The emphasis was on the development of each individual therapist's competency, the isomorphic relationship between the supervisor, group, therapist, and family levels of the therapeutic system, and the legitimacy of the term "peer supervision." Beginning under the leadership of an expert supervisor hired from outside the group, the Family Therapy Consortium has developed into a peer supervision group with a "floating," rather than fixed, supervisory hierarchy. The present paper charts this development and explores the peer supervision process as it currently works in the Consortium. The focus is on the growth of the individual behind the mirror as therapist, person, leader and group member, and on the growth of the group as a "mature sibling subsystem" no longer in need of outside supervision. Individual and group development are seen as complementary aspects of the same growth process.     

ORGANIZATION OF EXPERIENCE AMONG FAMILY MEMBERS IN THE IMMEDIATE PRESENT: A GESTALT/SYSTEMS INTEGRATION

How processes of family functioning are conceptualized influences a therapist's understanding and use of immediate experiential phenomena in the therapy setting. This article outlines two basic formulations that generate different conceptual perspectives of immediate phenomena. One recognizes that the family system has a time-enduring stability, while the second postulates that the family system has an immediate and temporary organization. The latter position is developed as an appropriate and useful application of systems thinking. Integrating systems thinking and Gestalt Therapy provides a framework for this application, one that recognizes individual experience as organized and as embedded in a mutual causal, self-maintaining system of the whole. The nature of such wholes, how they maintain their stability, their potential for change, and implications for therapy are described.     

THE FEMINIST CRITIQUE IN EPISTEMOLOGICAL PERSPECTIVE: QUESTIONS OF CONTEXT IN FAMILY THERAPY

Family therapy's neglect of social context as a factor in its continuing distortion of women's issues has led feminist critics to wonder if systems-based psychotherapy truly serves women. Rather than heralding the demise of family therapy, however, the feminist critique is here taken to open up concerns central to the epistemological discussion underway in the field. At first, these have to do with the functions of "punctuation,""boundary" and "closure" in systemic epistemology. Later, the central question becomes that of the place given to context in systems epistemology generally, as well as family therapy in particular. Several implications of a more lively interest in context for family therapy's work are explored. These are discussed with respect to women's issues, clinical epistemology, and the challenge to raise novel questions in family therapy.     

THE REPRODUCTION OF FAMILIES: THE SOCIAL ROLE OF FAMILY THERAPY?

Family therapy, while highlighting the significance of family functioning for individual experience and behavior, has in general failed to respond to the critical analyses of the family that have recently been developed, and particularly that offered by the women's movement. Consequently, it cannot investigate the possibility that "dysfunction" in families is actually socially created and maintained. Family therapy's failure to consider the broader contexts of family functioning, a failure that is facilitated by the use of systems theory as its major theoretical underpinning, results in an uncritical acceptance of the contemporary family form.     

Abstracts

Ahrons, C. R. Divorce: A crisis of family transition and change. Family Relations ,
Elmer, E. Child abuse and family stress. Journal of Social Issues .
McCubbin, H. I. Integrating coping behavior in family stress theory. Journal of Marriage and the Family ,
Reiss, D. & Oliveri, M. E. Family paradigm and family coping: A proposal for linking the family's intrinsic adaptive capacities to its responses to stress. Family Relations ,
Richman, J. The family therapy of attempted suicide. Family Process ,
Stanton, M. D. Family treatment approaches to drug abuse problems: A review. Family Process ,
Unger, D. G. and Powell, D. R. Supporting families under stress: The role of social networks. Family Relations ,
Wiseman, J. P. The "home treatment": The first steps in trying to cope with an alcoholic husband. Family Relations ,     

Capitalism,Protestantism and the Private Family: Comparisons among Early Modern England,France, and the American Colonies*

The study of western family change lies disintegrated, divided into two largely independent intellectual communities–family history and theoretical family sociology. An integration of the two fields is proposed. The results of family historical research from three national cases, England, France, and the North American Colonies, are used to evaluate critically the family theories of Parsons, Seccombe, Zaretsky, and Horkheimer. The pattern of family organization regarded as modern, including the differentiation of the family from other social institutions, the emergence of companionate marriage, and the consolidation of authority over the family in the role of the father, characterize the family systems of England and the Colonies better than that of France. A theory of modern family organization is proposed that identifies the emergence of a culturally dominant middle class and the institutionalization of Protestantism as facilitating conditions for the development of this private family system.     

Therapeutic ritual. Helping families grow

1. Family development can be inhibited by lack of social or family rituals to facilitate life cycle transitions. Therapeutic rituals can be used to help families mobilize their resources for healing, growth, and change. 2. A therapeutic ritual can help a family to resolve conflicts and resentments, to negotiate new roles and relational boundaries, and to develop new shared meanings among its members about their ongoing life together. 3. The success of a therapeutic intervention is influenced by the nurse-therapist's understanding of the family's culture, values, and needs, as well as familiarity with the directive nature of strategic therapy concepts on which therapeutic rituals are based.     

Bringing Two Worlds Together: A Collaborative Interview With JoEllen Patterson

JoEllen Patterson is Professor in the Marital and Family Therapy Program at the University of San Diego. She is also an Associate Clinical Professor of Family Medicine and Psychiatry at the University of California, San Diego, directing a medical family therapy clinic embedded in a Family Medicine residency (equivalent to General Practice in New Zealand). She also works in Pediatrics and Reproductive Medicine at UCSD. At present her work involves training family therapy students and family medicine residents to do interdisciplinary work using a biopsychosocial model. Research suggests that our bodies are influenced by our mental health; our immune systems and cardiovascular systems seem especially susceptible to mind‐body interplay. JoEllen is particularly interested in how family functioning influences the mind‐body system. In 2003, JoEllen Patterson received a Fulbright Senior Scholars award to visit the Wellington School of Medicine and Health Sciences, and the Child, Adolescent and Family Service in Lower Hutt, New Zealand. She spent two weeks between the clinical service and the academic department, teaching, consulting and advising. I was lucky enough to arrange this posting and to spend time with her during it.     

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.     

The Role of Values and Unity in Family Businesses

This study tests the application of an ecosystems perspective on family businesses. Specific focuses are given to values, resources and unity within family businesses. Two separate samples are examined, the American Family Business Survey and a multilevel sample. Results from this study support the ecosystems perspective. Family businesses are shown to vary by their value for family growth in comparison to business growth. This value variation across family businesses was shown to predict internal goals and resource transfers within family businesses. This study also shows the benefit to family businesses in unifying values across individuals, as unity of values is a stronger predictor of satisfaction even when controlling for the family business’ tendency to privilege the family or business growth.     

Attachment,Parenting, and Obesogenic Behavior: A Dyadic Perspective

Pediatric obesity is a growing health concern afflicting the United States. The treatment for pediatric obesity, as a health epidemic, costs billions of dollars to our nation, leaving providers and researchers searching for effective and sustainable ways to better manage the biological, psychological, and social health of individuals and families. While many assessments and interventions continue to emerge, researchers have predominately focused on intra-individual concerns among white non-Hispanic populations. This quantitative study was grounded in a relational theory (attachment theory), with a dyadic and primarily Hispanic sample. Evidence from our study supported that child attachment predicted child obesogenic behavior and that this relationship was mediated by child self-regulation. Children with insecure attachments had more obesogenic behaviors and lower self-regulation of eating than those with secure attachments. Family therapists should be on the frontlines of relational research and clinical interventions that interface with biopsychosocial health across diverse cultures and families     

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.