Child-Focused Family Therapy: Behavioural Family Therapy Versus Brief Family Therapy

We examined the effectiveness of behavioural family therapy (following the treatment agenda outlined in Fleischman, Horne and Arthur, 1983) and brief family therapy (following the procedures outlined in Fisch, Weakland and Segal, 1985), in the treatment of child psychological disorders. The parents of the 49 children referred to the outpatient unit of a children's hospital completed the Child Behavior Checklist (CBCL) (Achenbach and Edelbrock, 1983). Three scales of the CBCL were examined to assess the effectiveness of the two therapeutic approaches pre- to post-treatment. Significant pre- and post-treatment differences were found for behavioural family therapy on the Internalizing, Externalizing, and Sum T scales and for brief family therapy on the Internalizing and Sum T scales. Sum T scales represent the sum of scores across all sub-scales of the CBCL. Neither treatment was found to be more effective than the other.     

Out of the Darkness: Three Waves of Family Research and the Emergence of Family Therapy for Lesbian and Gay People

Like family relationships themselves, the history and treatment of lesbian and gay people and their families is complicated. For this paper, three waves of research on the families of gay and lesbian individuals are described. During the first wave, gay and lesbian sexual orientation was seen as a disease and family dynamics were blamed for its genesis. Subsequently in the second wave it was believed that, fearing rejection many gay and lesbian people either distanced or were rejected from their own families and established friendship networks that have been described as families of choice. More recently, in the third wave, the family has been identified as a resource for lesbian and gay youth whereby open relationships with parents can help protect them from mental illness, substance abuse, and HIV risk. Furthermore, an increasing number of same-sex couples are choosing to become parents, overcoming biological and social obstacles. In this article these shifting views of the role of family in the lives of lesbian and gay people will be described along with case material that illustrates the historic influences, current developments and future directions of family treatment for this population. To be maximally effective with gay and lesbian people and their families, clinical social workers and other mental health professionals must understand how family therapy has been influenced by a progression of ideas that continue to evolve. In this paper, research examining the role of the family in the lives of lesbian and gay people will be described in three waves; as a source of blame, to an impediment to gay and lesbian happiness and ultimately a resource that can enhance lesbian and gay well-being. The influences of research on family therapy with this population will be described and case examples will demonstrate how to harness the strengths of family relationships identified in the most recent wave.     

Family Work in Oncology: Trusting the Narrative

The author describes her work with a dying patient, work that extends from the patient to his wife and adult offspring, and has transformative benefits for the family.     

Family Therapy for the Trainee in Family Therapy*

The growth and self understanding of the therapist as a person are considered by most training centres to be a significant part of the training process. This article reports on a pilot project which provided marital and family therapy for trainees in a two-year program. Therapy was established on a contract basis and included individual, conjoint, family intergenerational and small group. Interns and family members responded favorably to the program. Supervisors found the experience enabled trainees to maintain an experiential consistency with a general systems model utilized as the core theory of the training program.     

A view from 1991: Crisis: Home-Based Family Therapy

Originally prepared for publication in 1991, but now appearing for the first time, this article discusses home-based family therapy in the context of families experiencing psychiatric crises. Strategies of engagement, interventions and safety issues related to this form of family therapy are outlined. The advantages of home-based family therapy in terms of direct observation and intervention and the minimisation of the need to transfer learning are discussed. Reflecting from the perspective of the present, the author notes with regret that most crisis teams today do little more than gatekeeping; a great opportunity for effective home-based treatment appears to have been lost.     

Teasing Out the Lessons of the 1960s: Family Diversity and Family Privilege

The tumult of the 1960s brought new strains of cultural relativism. I survey the continuing impact of some of these strains on family studies, focusing especially on the study of family diversity as an offshoot of the relativistic project. A dominant discourse still drives much of our work, however, and I illustrate it with some recent examples. The diversity agenda is hampered too often by unintended erasures of large categories of people in nondominant family arrangements. As a corrective to this tendency, I propose an agenda to study family privilege and entitlement, that is, to treat it as a “social problem” much as we treat poverty or juvenile delinquency. I illustrate with my own narrative of how I learned privilege and entitlement growing up male in a White, Jewish, upper‐middle‐class family. I end with some recommendations about how we might bring this agenda into our research and writing.     

The Theory Behind the Traps — Considerations for the Practice of Family Therapy in a Multi-frame Work Team*

Family systems theory as an approach to problem generation and change is practiced in many settings where other theoretical stances are also held. The issue of successful team work within a clinic where other therapists work from psychoanalytic and behavioural models is addressed. Structural, strategic and systemic approaches are compared with the psychoanalytic and behavioural. Particular attention is paid to apparent similarities between psychoanalytic and systemic family therapy theory. It is concluded that basic differences exist which make successful merging of the two views impossible. Practical examples of difficulties and attempted solutions are offered.     

Family Therapy Process in a Family Therapy Seminar

The interaction between leaders and members in a year-long family therapy seminar is systematically compared to the process that unfolds between therapist and family during the course of family therapy. A five stage developmental process common to both is postulated and described: (1) Battle for Structure, (2) Naive Enthusiasm, (3) Conflictual Frustration, (4) Task Orientation, and (5) Mutuality. The dynamic elements of each stage are analyzed and factors affecting their development are identified. It is concluded that this five stage process occurs in all similar groups, but that the content of each stage may vary widely from group to group.     

Walking Out of the Family Towards Rights

WALKING in any city or ruralarea in China today, one will seewomen with confidence andpride, with their own work and lives.There is not much difference between theurban and rural women in dress. Theirfaces portray contentment and happiness.These are significant changes which havebeen brought about by women walking outof the family over the past near 50 years,and getting involved in society, alteringtheir dependence on men and making thempeople of dignity. The government knew clearly that to     

Using Family Attachment Narrative Therapy to Heal the Wounds of Twinship: A Case Study of an 11-Year-Old Boy

This paper describes the utilization of Family Attachment Narrative Therapy with an 11-year-old boy experiencing significant behavioral and developmental problems emerging from his experience of identical twinship and associated parental failure. This innovative treatment model is demonstrated to be a useful tool for changing the child’s faulty self narrative resulting in improved functioning. The critical element of the reworked schema is the perception of self as complete, adequate, worthy and cherished. Family Attachment Narrative Therapy is also shown to facilitate increased parental attunement to the child’s inner state and parent-child bonding. This study highlights the unique developmental challenges facing young twins and the related complexity of the parental role.     

Critiques of Narrative Therapy: A Personal Response

This paper responds to some of the specific and the generalised challenges to narrative therapy from therapists of other persuasions. It discusses the long history of model rivalry and locates this debate in that process. It also takes up specific concerns of isolationism, desertion, language, sectarianism, colonialism and ethical superiority. Throughout, I attempt to identify my thinking in relation to the criticisms, and to write transparently about why I understand things in the way I do. This is not a neutral paper — I see myself as a narrative therapist.     

Paining Out: An Integrative Pain Therapy Model

This article describes and evaluates an integrative pain therapy model as a beneficial form of pain-management for chronic pain. The author based his model on cognitive-behavioral modalities, progressive relaxation combined with art therapy, sensory awareness combined with indirect clinical hypnosis, formal clinical hypnosis and self-hypnosis. Those techniques were applied in small group settings to systematically alter pain perception, pain interpretations and response to pain for the group participants’ benefit. As a result, the group participants gained a greater sense of control over the pain, eased or abolished the pain, and decreased the stress, anxiety and depression associated with chronic pain. The techniques used were synthesized into ten group therapy sessions. A small data sample suggests that the model has clinical utility and maintained its benefits in a 6- to12-month follow-up.

Object Relations Family Therapy: Articulating the Inchoate

In recent years there has been a renewed interest in psychodynamic ideas within the family therapy literature. While some authors have explored the usefulness of psychodynamic concepts in the systemic context (Byng-Hall, 1995; Flaskas, 1993, 1996; Luepnitz, 1988, 1997), others have argued that psychodynamic models of family therapy should be given more credence in systemic work with families (Guttman, 1991). This paper describes Object Relations Family Therapy (ORFT), a psychoanalytic model of family therapy, in plain English in order to minimise the obscurity of some of the existing terminology and to emphasise the utility of more contemporary formulations. ORFT addresses the interface between psychoanalytic and systemic theories. It offers a way of conceptualising complex family dynamics at both the interpersonal and intrapsychic levels. It also integrates an understanding of nonverbal, unstated and often implicit processes in its formulation of problem development. The unique contribution of ORFT is elaborated using a clinical example.     

Interactive Family Music Therapy: Untangling the System

Interactive Family Music Therapy can have a unique role to play when working as part of a multidisciplinary team by demonstrating a capacity to ‘surprise’ a client/patient when they least expect it. It provides a positive shared experience that can add to multidisciplinary assessment and treatment planning. This article will illustrate the role Interactive Family Music Therapy has at Redbank House and includes case material.     

Working with the One-Parent Family in Family Therapy

This paper describes the particular problems that arise in the treatment of one-parent families. These problems are seen as stemming from the experience of disruption in the life of the family and the resulting special family structure. Techniques of handling the various resistances and issues that surface are presented and discussed. A case report illustrating many of the points made in the body of the paper is included.     

Depression,the Family,and Family Therapy

The potential contribution of family therapists to the treatment of depression remains underdeveloped. Family therapists need to articulate how changes in family functioning might benefit depressed persons, as well as how other problems in the families of depressed persons tend to go unrecognised. Furthermore, family therapists need to be alert to how undetected depression in adults and children may interfere with their ability to meet their goals with families who seek therapy for other persons. This article provides family therapists with (1) an overview of the nature and experience of depression; (2) an introduction to antidepressant medication; (3) a summary of research findings relating depression to its family context and (4) a brief overview of developments in the marital and family treatment of depression.     

Para-Modern Family Therapy: Deconstructing Post-Modernism

As in the arts and humanities and other social sciences, post-modernism is quickly gaining orthodoxy in family therapy. This paper presents a social-realist and deconstructive critique of recent post-modern thought in family therapy. From the perspective of the French philosopher Jacques Derrida, it suggests that family therapy is neither modern nor post-modern, but both/and these alternatives, that is, para-modern. In deconstructive thought, philosophical dualities like realism/social constructionism, cybernetic/post-cybernetic, systemic/narrative co-exist in an absurd double logic. Like writers of literature, the para-modern family therapy ‘puts forward’ a theory or method not as an ideology of truth, but as a play of irony. She/he works simultaneously inside and outside family therapy discourse, open to a wide range of images and metaphors.     

Family Therapy: A Client-Centered Perspective

>This article first critiques therapist-directed approaches to family therapy in the light of research findings on therapist variables (empathy, warmth, genuineness) associated with positive outcomes in psychotherapy. Second, two polar opposite positions in family therapy — psychodynamic and family systems — are examined and found to have much in common. The two approaches are based on a pessimistic view of the family, which is seen as an intractable unit, resistant to its own growth. Third, an alternative, phenomenological view of the family is developed, which more optimistically assumes the family to be motivated for enhancement and growth. Finally, a client-centered approach to family therapy is described.