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.     

EVALUATION OF AN ACADEMIC FAMILY THERAPY TRAINING PROGRAM: CHANGES IN TRAINEES' RELATIONSHIP AND INTERVENTION SKILLS

Students in an academic training program were assessed for changes in their relationship and intervention skills following completion of the program. Positive improvements were found on some measures but not all. Additionally, trainee variables such as previous clinical experience. gender, age, marital stauts and scores on standardized admission tests were examined in relation to trainees' skills changes. Trainee characteristics were unrelated to changes in intervention skills. However, a number of relationships were found between trainee characteristics and changes in relationship skills.     

USING THE TELEPHONE IN FAMILY THERAPY

This article explores use of the telephone as a communication medium for engaging families in the therapy process. A review of related literature is followed by an exploration of some of the challenges involves. The author offers suggestions for conducting phone sessions, provides a case example, examines some of the ethical issues involves, and ponders the possible future impact of advanced telephone-related communication technology on family therapy.     

COST EFFECTIVENESS RESEARCH IN FAMILY THERAPY*

The authors attempt to demystify the process of conducting cost effectiveness research by defining relevant terms and decribing the necessary steps. Two provious cost-effectiveness studies of family based treatment are briefly described to illustrate cost-analysis procedures that may be used in future family therapy research.     

CLINICAL PROCESS RECORDING IN FOCAL FAMILY THERAPY*

A method for systematically recording the process of family therapy (the Focal Therapy Record Sheet) is described, based on the focal approach developed in earlier papers by the authors. It demands a conceptual distinction between assessment of families and treatment techniques and embodies continuous evaluation of family improvement according to specific criteria. A detailed case illustration showing the Sheets completed for each of 14 sessions after two diagnostic interviews is provided, together with an anecdotal-style account. The value of the instrument for teaching purposes, in routine clinical work and for research is discussed.     

FOUR USEFUL INTERVENTIONS IN BRIEF FAMILY THERAPY*

At the Brief Family Therapy Center we have developed some interventions that have repeatedly been found useful. Once a generalizable intervention is designed for a particular case and found effective, the team attempts to replicate by using it in other appropriate situations. When a pattern of usefulness emerges, it is time to think about and study what is going on that makes the intervention useful. The purpose of this paper is to describe four such interventions, the situations in which to use them or not use them, and our thinking about what is going on in each example.     

ESSENTIAL ELEMENTS OF A FAMILY PSYCHOEDUCATION PROGRAM IN THE AFTERCARE OF SCHIZOPHRENIA*

This paper describes a psychoeducation program designed for families and caregivers of patients who suffer from schizophrenia on an inpatient ward of an acute care hospital in a major metropolitan city. It is based on 10 years of experience working with over 600 relatives and caregivers. It discusses the research pertinent to developing such a program, the five elements the authors consider necessary to its success, and the stages of the actualprogram. The five elements include universal service, crisis intervention, social functioning of patient and famly, 2 years continuity of care postdischarge, and the role of the family clinician. It addresses issues raised by working as a muultidisciplinary team and problems in service delivery. A case history illustrates the process.     

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 NATIONAL MARITAL AND FAMILY THERAPY EXAMINATION PROGRAM

Examinations constitute one of the principal methods by which professions assess minimal competence in aspiring practitioners. The Examination in Marital and Family Therapy is used by most states which regulate the profession. This article provides the rationale for the examination program, describes its development and maintenance, and presents the knowledge base it samples. Administrative policies and procedures are also discussed as an aid to prospective licensure and certification candidates.     

NONCONFRONTIVE USE OF VIDEO PLAYBACK TO PROMOTE CHANGE IN BRIEF FAMILY THERAPY*

This paper describes a nonconfrontive use of video playback in brief family therapy. Replaying critical transactions from previous sessions, while maintaining a neutral and nonconfrontive therapeutic stance, encourages an atmosphere which is conducive to change. The technique allows family members to reexperience their own interactional patterns in a nonthreatening manner, enabling them to consider the meanings they attach to their family experience in different and productive ways.     

EMPIRICAL VALUES AND THE CULTURE OF FAMILY THERAPY*

The research-clinical practice connection is weak in family therapy. Some have argued, in an inordinate ideological and political tone, that traditional research methods are inappropriate for family therapy. This position mischaracterizes modern day clinical researchers and research. In presenting 10 key dimensions of the research-clinical practice issue in family therapy, this paper addresses some of these misrepresentations. If research and practice are to interact more productively, a major commitment, the scope and implications of which have not yet been realized, will need to be made. Actualizing the research-practice link is a training problem and a fundamental professional issue. Progress in this realm would change the particulars of clinical practice as we know it. These processes will involve nothing less than remaking the culture of family therapy.     

THE POLITICS OF GENDER IN FAMILY THERAPY

This article provides an overview of the political implications of various approaches to gender within the clinical literature. It emphasizes the process of the rapy within the social context of gender relations and identifies the politcal consequences of various clinical responses. Issues surrounding the appropriate role and stance of therapists relative to gender are identified, ethical issues such as neutrality and client welfare are re-examined, and suggestions for practice are addressed.     

SUPERVISION IN FAMILY THERAPY: A DECADE RESTUDY*1

This paper reports on a 10-year replication of Everett's (1980) survey of Approved Supervisors of the American Association for Marriage and Family Therapy (AAMFT). Significant differences were found between today's supervisors and supervision, including an increase in female supervisors, a shift toward a systemic theoretical orientation, greater concentration of supervisors in formal training settings, a great increase in the use of video recordings, a decline in the popularity of personal psychotherapy as part of training, a greater inclination of supervisors to identify themselves as Marital and Family Therapists (MFTs) regardless of original education, and others. The Approved Supervisor system appears to be fulfilling AAMFT organizational goals; other results will be reported elsewhere.     

THE MARITAL AND FAMILY THERAPY EXAMINATION PROGRAM: A SURVEY OF PARTICIPANTS

Participants in the Examination in Marital and Family Therapy between November 1994 and May 1996 were surveyed to ascertain who took the examination, how they prepared for it, whether they thought that it was fair, and how these variables related to scores. Two-thirds of the respondents were female. Most were taking the examination for the first time, were relatively young, were Caucasian, and spoke English as their primary language. They primarily practiced marital and family therapy and had completed master's level university programs in marital and family therapy, counseling, and psychology. Most were sitting for the examination relatively soon after completing their training in marital and family therapy. Individual study was the preparation method of choice for half of the sample. Demographic variables had a modest but ambiguous effect on test score. Educational background had none. However, a relatively short latency between graduation and examination was related to a higher score, as was the use of multiple preparation procedures. With regard to fairness, the participants largely agreed that the examination was moderately difficult, but that the problems were realistic and they had enough time to complete the test.     

A MODEL FOR TRAINING PRACTICING PROFESSIONALS IN FAMILY THERAPY*

This paper offers a model for high quality training in family therapy. The unique aspects of the Family Consortium's model are that it: (a) is aimed at practicing professionals; (b) emphasizes structural family therapy principles with strategic and experiential elements; (c) is geared secondarily toward training members as effective peer consultants and trainers; and (d) uses an awareness of the isomorphic nature of training, therapy and family transactions. Part I describes the practical organization structure of the Consortium. Part II discusses the current theoretical philosophy and training approach of this evolving group. Examples are given of how the Consortium has dealt with specific training issues.     

FAMILY THERAPY AND QUALITATIVE RESEARCH*

Qualitative research is becoming accepted by the scientific community as a viable way to explore and understand socialscience phenomena. The purpose of this paper is to describe the essential features of the qualitative research paradigm and to encourage further development of that paradigm in the field of family therapy. First, typical characteristics of qualitative research designs are delineated; these characteristics are illustrated with two extended examples from the qualitative research literature in the field of education. Next, possible applications of the qualitative paradigm to research issues in the field of family therapy are discussed. Finally, potential pitfalls that could inhibit the development of qualitative family therapy research are examined. It is hoped that this paper will serve as a stimulus for the development of qualititative research in the field of family therapy.     

A FEMINIST FAMILY THERAPY SCALE*

This paper reports on the development and psychometric properties of a 17-item instrument intended to reflect the degree to which family therapists conceptualize the process of family therapy from a feminist-informed perspective. Items were adapted from those generated by 37 feminist-informed family therapists in a previous study. Factor analysis results on 383 subjects reflect a unidimensional scale. The Feminist Family Therapy Scale had a Cronbach Alpha of 83 and was found to discriminate between (a) self indentified feminists and nonfeminists, (b) women and men, and (c) subjects scoring higher on Scanzoni's (1975) Sex Role Modernity Scale and those scoring lower. Additional psychometric data are reported, and possible uses of this scale are discussed.     

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.