Family Therapy with Adolescents: Giving Up The Struggle

This paper examines problems in adolescence from the perspective of a power struggle between parent(s) and teenager. The structural approach of Minuchin and the strategic approaches of Haley, Madanes, and the Mental Research Institute (M.R.I.) are considered in relation to the significance they attribute to power and power struggles in families with adolescents. It is argued that the M.R.I. approach has certain therapeutic advantages for working with problematic adolescents, primarily because of its focus on understanding and intervening in the power struggle itself. A focus on the power struggle as the ‘problem’ reminds the therapist of the circular nature of parent-adolescent interactions. This awareness assists the therapist to design indirect interventions that are less likely to become absorbed into this vicious cycle. It also encourages a therapeutic stance that prevents the therapist from becoming involved in a power struggle with family members.     

Ethics and family therapy: the case management of family violence*

All family therapists, and especially Milan-style systemic therapists, have been trained to take a neutral stance regarding family issues, based on a circular causality model of family interaction. Therefore, when therapists deal with family violence, their ability to perceive individual responsibility for unethical behavior is weakened or suppressed. In fact, this ability is the primary tool in developing effective treatment planning in cases of family violence: The actively physically abusive man needs to be in individual and/or group therapy, not conjoint or family therapy. The ethical judgment of the therapist is what determines the limits of family therapy.     

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.     

Constructive hypothesizing,dialogic understanding and the therapist's inner conversation: some ideas about knowing and not knowing in the family therapy session

The primary tasks of the therapist can be described as listening to what the client says and making space for what the client has not yet said. According to Anderson and Goolishian, the therapist should take a not-knowing stance in this dialogic process. The question remains, however, what not-knowing exactly means. In this article, I will explore this question and I will propose the concept of constructive hypothesizing. Constructive hypothesizing is described as a process in which there is a movement back and forth between knowing and not knowing. Of central importance are creative and dialogic understanding, rather than knowledge. Recommendations are made to ensure the constructive and collaborative use of hypotheses in the therapeutic dialogue.     

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.     

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     

From Private Practice to Academia: Integrating social and political advocacy into every MFT Identity

While advocacy was essential to establishing the field of marriage and family therapy, at present a social and political advocacy skill set is lacking for the typical marriage and family therapist (MFT). This article reviews the importance of being active in social and political advocacy and highlights the attributes of MFTs’ professional identity that uniquely position us for success in these areas. Other mental health fields’ pedagogical approaches to training and education are explored, and recommendations are made for how MFTs can begin to increase their competency in advocacy. Ideas for incorporating advocacy into a professional identity are presented for MFTs at every level of professional experience. Finally, the concept self‐of‐the‐advocate is introduced and discussed.     

On ‘flip‐flopping’: Branded stance‐taking in U.S. electoral politics1

This article examines stance in U.S. political discourse, taking as its empirical point of departure Democratic candidate John Kerry's epistemic stance‐taking in the televised 2004 presidential debates. Kerry's stance‐taking is shown to help display the characterological attribute of ‘conviction’ and serve as a rejoinder to critics who had branded him as a ‘flip‐flopper.’ His stance‐taking is thus not primarily ‘to’ or ‘for’ copresent interactants, but is largely interdiscursive in character. ‘Conviction’ and its opposite, ‘flip‐flopping,’ suggest further how stance‐taking itself has been an object of typification in the agonistic dynamics of candidate branding and counter‐branding. In moving from epistemic stance‐taking in discourse to models of the stance‐taker as a social type, this article addresses questions about the units and levels of analysis needed to study stance in contemporary political discourse.     

Live Consultation Without A One-Way Screen†

This article is about a method of teamwork in which both the therapist and the consultant are present in the same room as the family. It distinguishes between the therapeutic team of consultant and therapist and the therapeutic system of consultant, therapist and family. It outlines some particular advantages and disadvantages which are present when working in the same room as the family and emphasises the importance of the careful preparation and maintenance of the therapeutic team if its creative potential for the family is to be fulfilled.     

In the Right Place at The Right Time: An Interview with Brian Stagoll

Few in Australia have done more than Brian Stagoll to develop and critique a local family therapy within an international context, to define its political and intellectual challenges, and to give the field organisational substance. He has been at the centre of Australian family therapy for more than two decades, as both creator and iconoclast. Brian is a psychiatrist who has always pursued social justice and community health initiatives along with a busy life as a therapist, and is a keen reader of history, politics, philosophy and literature. He was a co‐founder of our annual conferences. He co‐founded and organised the Williams Road Summer Schools in the 1980s. He was a co‐founder of this journal, its first Associate Editor and book review editor. He has contributed some of our most significant papers, as well as publishing elsewhere nationally and internationally. He was influential as a Board member and later as President. He is an Honorary Life Member of VAFT, which he co‐founded, and in 2001 he received — in his home city of Melbourne — the Journal Award for outstanding contributions to family therapy.     

Empathy — Still at the Heart of Therapy; The Interplay of Context and Empathy

Developing skilled and delicate approaches and interventions aimed at assisting families (or systems) to solve entrenched problems has been an exciting and stimulating aspect of family therapy over its relatively short existence. Recently, more and more authors have re-emphasised the need for respect and mutuality in dealing with clients, the need for the therapist to be aware of the clients' frames of reference and idiosyncratic solutions, some arguing that it is preferable to take less of the expert, interventionist stance. The necessity for empathy underlined in many earlier approaches to therapy is mentioned, though generally ‘in the small print’, in the reports of the processes being investigated and developed. This article re-considers empathy, always known to be at the heart of the counselling/therapy¹ process, but perhaps too easily assumed at present. It contends that empathy remains essential, that it can be understood more fully, and thereby used more effectively. Some of the traditional understandings of empathy, mostly from writings on individual therapy, are considered. Working with families and systems demands a broader understanding and different applications. The therapist must be capable of empathy with the context and the relationships as well as with individuals. While asserting that human beings are generally capable of empathy, the article examines some particular aspects of its use in therapy, particularly with families; it contends further that a fuller understanding of empathy can enrich the whole process of therapy. The article argues that empathy remains an indispensable guide to intervention with the family, the system or the person, whatever form the intervention (or non-intervention) may take.     

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.     

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.     

Vicarious resilience from attachment trauma: reflections of long-term therapy with marginalized young people

The concept of vicarious resilience captures the therapist's emotional growth occurring as a direct result of therapeutic engagement with traumatized clients. Three chronological case scenarios are presented for exploration of vicarious resilience in relation to attachment trauma. The purpose is to increase awareness and appreciation of the positive functions it serves for client mentalization, therapist skill and resilience factors for both parties. The reflective methodology considers the intrapsychic worlds of the client and the therapist and details how the therapist comes to experience the client's distressing projections. The potential for vicarious resilience begins from the outset of the therapist's actions of containment upon these projections. Advancing early ideas, it is advocated that vicarious resilience requires the therapist to have both the capacity and willingness to maintain a constant reflective stance.     

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.     

On Learning and Teaching Family Therapy

This paper explores some ideas about the process of learning to be a family therapist. It considers the questions: how does one learn to think like a family therapist? How is family therapy best taught? How is it learned? The author's experiences in learning and teaching are described. It is argued that family therapy differs from other approaches to therapy in some fundamental respects, and that learning to ‘be’ a family therapist is a different kind of task than learning to be a practitioner of other therapeutic approaches. The paper examines some key theoretical constructs, especially the idea of ‘levels’ of thinking, which are seen as central to both the learning and practice of family therapy.     

DO WE REALLY UNDERSTAND? AN EXPERIENTIAL EXERCISE FOR TRAINING FAMILY THERAPISTS

This paper presents an experiential exercise for training beginning marriage and family therapists, as well as several adaptations of the format. The basic exercise consists of role playing a therapy session in which the people playing the clients speak a language that is not understood by the therapist-in-training. Although the therapist cannot understand the clients, the clients can understand the therapist. This exercise assists students to become more cognizant of the need to be cautious and curious in the cocreation of meaning in therapy. In addition, this exercise builds confidence and clinical skills, such as learning about nonverbal communication while observing process.