ECLECTIC STRATEGIC PRACTICE: A PROCESS CONSTRUCTIVE PERSPECTIVE

The development of an integrative individual and family therapy approach has been hampered by fundamental differences in philosophy and theoretical conceptualization among approaches. Given these largely irreconcilable differences systemic framework for a technical eclecticism may represent a logical step toward a more flexible consideration of both individual and family approaches. This article will describe an extension of the strategic therapy model that enables and encourages the selective application of content and techniques from individual and family approaches. Three case examples will illustrate a process-oriented, constructivist rationale for eclectic strategic practice as well as a more collaborative and relationship-oriented perspective of strategic therapy.     

THE INTEGRATIVE PSYCHOTHERAPY ALLIANCE: FAMILY,COUPLE AND INDIVIDUAL THERAPY SCALES*

The therapeutic alliance concept has been confined primarily to the literature on individual psychotherapy. This paper formally introduces the concept into the family and marital therapy domain and presents various clinical hypotheses about the nature of the alliance and its role in familyand marital therapy. A systemic perspective is brought to bear on the concept within individual psychotherapy. A new, integrative definition of the alliance is presented that conceptualizes individual, couple and family therapy as occurring within the same systemic framework. The implications of this integrative-alliance concept for family, couple and individual therapy research are examined. Three new system-ically oriented scales to measure the alliance in individual, couple and family therapy are presented along with some preliminary data on their methodological characteristics.     

Integrative Family Therapy for Child Behavioural Problems in a Parenting Support Agency

This paper describes family therapy for behavioural problems in a parenting support agency. It discusses the literature on the effectiveness of family therapy with child behaviour problems within a community support environment. The paper presents a detailed family case study, which is discussed from an integrative family therapy framework. Narrative therapy is used as an overarching framework for integrating systemic therapy and parenting skills to help a family with a mixed cultural Aboriginal and Australian background. This allows sessions that are meaningful for the family and encourages a connection to their own resources and to their community, besides creating a safe space for a dialogue that hears and values all voices.     

Theorizing fields

Field analysis, inspired largely from the work of Pierre Bourdieu, is becoming widely used in sociology today. In A Theory of Fields Neil Fligstein and Doug McAdam elaborate selectively on Bourdieu’s thinking to offer a conceptual framework for better understanding the creation, institutionalization, and transformation of “mesolevel social spaces” where actors compete, often through cooperation and coordination, for material and status rewards. In lieu of calling those spaces markets, organizations, networks, systems, or institutions, as is commonly done in the specialized subfields of social movements, political sociology, organizations, and institutional work in political science, FM propose the language of “strategic action field.” They argue that their strategic action field perspective can link agency to structured social spaces and serve as an integrative conceptual umbrella for these fragmented subfields of scholarly specialization. This review presents and evaluates this intellectual field strategy to provide a common and integrative conceptual framework, while calling attention to its key strengths and weaknesses.     

Integration of Daniel Stern's developmental theory into a model of couples therapy

Therapists commonly use a combination of techniques derived from psychodynamic, cognitive and systemic approaches in their attempts to treat the resistant patterns brought into therapy by couples. In this paper we utilize Dan Stern's concept of RIGS (Representations of Interactions that have been Generalized) to generate an integrative model of conjoint therapy. The model presented here presents a framework within which these modalities can be effectively integrated.     

Determinants of Nonprofit Sector Density: A Stakeholder Approach

Why do nonprofit organizations exist? From an economic perspective, a number of major theories have been proposed to explain their existence. However, when exploring determinants of nonprofit sector density, one needs to take into account that demand and supply factors operate simultaneously and that it is difficult to separate them. By using a stakeholder approach, we develop a more integrative framework for understanding variations in nonprofit sector density. We test this framework by investigating determinants of nonprofit sector density in Texas at the county level.     

Relational Family Therapy as an Aid Toward Resolving the Trauma of Sexual Abuse in Childhood in the Process of Separation in the Couple Relationship

Relational family therapy (RFT) is a psycho‐organic therapeutic approach that combines intrapsychic dynamics with interpersonal mechanisms and a systemic perspective. This integrative model is based on the assumption that the repetitive patterns of relationships in early childhood repeat in adulthood. It often happens that a sexually abused individual will later unconsciously be attracted to someone with whom they will relive the abusive atmosphere and dynamics from childhood. The purpose of this contribution is to present the RFT approach for dealing with sexual abuse. We will present a case study with individual segments from therapy with a woman, who previously had been sexually abused and was separated from her partner.     

A BLUEPRINT FOR INCREASING THE RELEVANCE OF FAMILY THERAPY RESEARCH

Family therapy research and psychotherapy research in general have been criticized for their lack of relevance to clinical practice. This paper presents a fivestage model that family therapy researchers can follow to increase the relevance of their work for clinicians and other consumers of family therapy research. Using lessons derived from private industry, the research model is based on a marketing and developmental perspective.     

An integrative contextual developmental model of male stalking

This article evaluates current research and theory on stalking as a form of male violence against women. The integrative contextual developmental model (White & Kowalski, 1998) suggests that stalking, as legally defined, is best understood as a multiply determined form of violence, with variables identifiable at several levels, the sociocultural, interpersonal, dyadic, situational and intrapersonal. The model also serves as a framework for identifying gaps in current research and suggests directions for further work.     

Assessment in Marriage and Family Therapy: A Review of Clinical Updates for Family Therapists

This article presents information from an integrative literature review that examined assessment processes presented to marriage and family therapists in Clinical Updates for Family Therapists, Volumes 1 (2005), 2 (2006), and 3 (2007). The study was based on the concern that marriage and family therapy is losing its systemic relational focus as practitioners must comply with diagnosis models using the Diagnostic and Statistical Manual of Mental Disorders. Using integrative literature review methods, similar to qualitative research, 54 articles were deconstructed to identify assessment tools and diagnostic processes being presented as best practice. Of the 54 articles, 96% identified the importance of having a family or couple relational perspective for working with individuals with mental disorders; however, only 54% provided any explanation to how this could be accomplished. These findings suggest a need to increase the identification of unique, relational assessment practices in articles that offer best practice techniques in marriage and family therapy.     

The Neurosequential Model of Therapeutics: An Interview with Bruce Perry

In this interview with Bruce Perry, MD, PhD, Senior Fellow of The Child Trauma Academy, Laurie MacKinnon discusses with Dr Perry developmental trauma and the Neurosequential Model of Therapeutics, an approach to clinical problem solving that utilises a developmental lens and incorporates advances in neurobiological development. Dr Perry gives his perspective on the causal connection between childhood abuse and later psychiatric diagnosis, the child's contact with a violent parent post‐separation, the importance of interventions that address the organisation and functioning of lower parts of the brain and his perspective on the use and limitations of psychotropic medications, cognitive behaviour therapy and family therapy.     

Transitional phenomena in adolescence: Tools for negotiating the second individuation

The purpose of this article is to heighten clinicians awareness of the integrative potential of transitional phenomena in adolescent ego development. A review of the literature and presentation of clinical examples support the author's contention that adolescents may employ transitional phenomena to assist them through developmental turbulence reminiscent of original rap-prochement crises in early separation-individuation. An understanding of how adolescent clients may use transitional phenomena provides clinicians with an expanded perspective for differential assessment and intervention.     

Anticipated dependence: A determinant in an integrative model of power relations among elderly couples

The study proposes an integrative, multivariate model for analysis of conjugal power relations among elderly married couples, from the perspective of the husband. The conceptual framework of the model is based on the well-known Resource Theory. However, in addition to the resources examined in other studies (e.g., economic and social resources), this model considers the husband's anticipated dependence on his wife as a potential factor that may explain conjugal power relations. The integrative model was tested on 211 elderly husbands in Israel. It was found that the primary variables explaining conjugal power relations in late adulthood are psychological-expressive in nature. Instrumental-economic resources were not found to have any explanatory power in the late stage of life. Traditional attitudes of the husband regarding the capacity of women to fulfill roles outside of the home correlated positively with his perceived power in the marital relationship. The findings indicate that the Resource Theory may be expanded and that anticipated dependence can be incorporated as a potential resource affecting current power relations among elderly couples.     

Reaching for Integrity: An Eriksonian Life-Cycle Perspective on the Experience of Adolescents Being Raised by Grandparents

Increasing numbers of children are being raised by their grandparents because their own parents are unable or unwilling to care for them. A case is presented illustrating how an Eriksonian life-cycle perspective clarifies the developmental demands on adolescents in these situations and provides a theoretical framework for organizing therapeutic work with them.     

The Developmental Life Course Perspective: A Conceptual and Organizing Framework for Human Behavior and the Social Environment

The developmental life course perspective (DLC) focuses attention on the socio-historical context in which we live our lives as it influences opportunities and life events that produce cumulative advantage or disadvantage. These large contextual forces shape preference and behavior, and it is within this context that the individual exerts personal agency. This perspective has particular utility as a conceptual framework for human behavior and the social environment courses as it integrates individual-level behavior within a social forces context. This article describes the DLC and its application as both a conceptual and an organizing framework for human behavior and the social environment courses at the masters level. It is illustrated with a case example.     

THE STRUCTURE OF FAMILY PARADIGMS: AN ANALYTICAL MODEL OF FAMILY VARIATION

The theory of family paradigms provides an integrative framework for under-standing and systematizing the diverse ways that families organize and make sense of family life. Using formal methods of analysis based on logical and geometrical arguments, the priecise implications of models of family types can be investigated and compared. The paradigmatic framework can thus be refined and extended to form a more rigorous theoretical grounding for family typologies is explored and a miltidimensional model is derived the geometry of which is equivalent to, but more succinctly captures, the underlying structure of uariation in family para-digms. In Part II, the resulting model is interpredtd and explored in terms of implications for family theory, theory construction, and family therapy. Clarifying the basic dimensions of the paradigmatic framework also permits more precise exploration of interrelationships among related models of family types, which can be understood as reduced models derivable from the complete geometry of the paradigmatic framework.     

Intimate Partner Violence

This article presents a developmental vulnerability/resilience and risk/safety framework to educate social work students about intimate partner violence. The framework adopts a multidimensional perspective to understanding development (a) among individuals who are violent toward intimate partners, (b) among those toward whom they are violent, and (c) within family systems; it also covers prevailing socio-environmental contexts. The utility of this framework for Human Behavior in the Social Environment (HBSE) education is discussed.     

Integrative Symptom-Focused Dynamic Psychotherapy

The advent of the relational perspective in psychoanalytic theory has opened up exciting new prospects for integrative psychotherapy. My own integrative model draws on self psychology and attachment theory for ideas about development and treatment, but also posits the need for active techniques at times to help with troubling symptoms. In addition to using interventions from behavioral and cognitive behavioral traditions, my treatment approach has been evolving to include a variety of mindfulness based strategies. In this article I focus on interventions I use most often to help patients with two major domains: self regulation (which includes affect management and perspective on the self), and self-initiated behavior change. Case examples illustrating the interplay of symptom-focused work and more dynamic exploration are provided.     

Thomas Szasz' “critical reflections on child psychiatry”: An alternative view through a systemic lens

In “Critical Reflections on Child Psychiatry,” Thomas Szasz (1979) argues that children are without the rights afforded adults, that children are often coerced into therapy, and that most children do not appear to benefit from psychotherapy. Szasz raises many pertinent questions for mental health professionals working with children. However, his arguments appear to be based on literature limited to traditional psychodynamic approaches. His position also neglects to consider literature in the developmental psychology and legal fields. This paper, written from the cognitive developmental and the family systems perspective, provides another examination of the important issues raised by Thomas Szasz.     

Emotionally Focused Therapy for Couples and Attachment Theory

Emotionally focused therapy for couples (EFTC) is an important framework for couples therapy. It provides an integrative model, drawing upon experiential, systems and attachment theory to understand the dynamics of the couple relationship and to describe the therapeutic process. The aim of this paper is to ask how EFTC uses attachment theory, and whether it draws as fully as it can upon the richness of that theory to inform the process of therapy. This is set in the context of the evolving importance of attachment theory for therapeutic work.