SNARES IN FAMILY THERAPY

Telephone calls after therapy sessions, concurrent individual treatment of family members, the offer of secret revelations, and the use of psychoactive drugs all involve issues and events that can be insidious to effective family therapy. Various tactics are presented which not only succeed in controlling these incidents, but which also use them as important occasions for therapeutic intervention within the model of family therapy developed by Selvini Palazzoli and her colleagues in Milan.     

ETHICAL DILEMMAS IN FAMILY THERAPY

A review of the literature in the area of ethical dilemmas facing family therapists revealed that there were a number of issues facing family therapists which are not included in the Principles for Family Therapists (1984) of the American Association for Marriage and Family Therapy. Seventy-five family therapists from across the nation responded to a questionnaire which asked what ethical dilemmas they face and how helpful the ethical guidelines are with these dilemmas. Results indicate that family therapists are encountering dilemmas which are not included in the Principles, significantly more often than those that are included. The ethical principles were found to be helpful for those ethical dilemmas attended to by the Principles.     

POSITIVE PRACTICE IN FAMILY THERAPY

Positive practice, a brief integative approach to consultation with families, is described in this paper. A clear distinction is made between the stages of planning, assessment, therapy, and disengagement. Guideliness for progression from one stage to the next are provided. Frameworks for deciding who to invite to preliminary sessions and methods for planning and organizing lines of inquiry are incorporated into this approach to practice. A three-column model is used to construct formulations. The model allows therapists and clients to map information about the pattern of interaction around the presenting problem, beliefs that constrain family members from altering their roles in these problem-maintaining patterns, and factors that have predisposed family members to hold these beliefs. Positive practice offers methods for evolving new behavioral patterns and belief systems within sessions and for arranging homework tasks for clients between sessions. It also incorporates methods for dealing with resistnace, for managing therapeutic crises, for convening indivudial sessions and borader network meetings, for disengaging from the consultation process, and for recontracting for further episodes of therapy. This evolving approach to practice draws on ideas from many traditions within the family therapy field and takes account of recent research relevent to the practice of family therapy.     

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.     

IDENTIFYING SEPARATION THREATS IN FAMILY THERAPY

Separation anxieties are a part of normal family life, whether they arise from the progress of children toward independence or from accidental crises, which threaten the integrity of the family (Argles & Mackenzie, 1970). Family conflict tends to heighten such anxieties, and moreover they are often deliberately or unconsciously exploited, for a variety of reasons. This exploitation usually takes the form of separation threats, either explicit or implied in certain types of family transactions. Children are especially vulnerable to such threats, and experience them more commonly than may be supposed (Newson & Newson, 1968).     

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.     

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.     

BASIC FAMILY THERAPY SKILLS,II: STRUCTURAL FAMILY THERAPY1

The Basic Family Therapy Skills Project has yielded empirically derived skills important for beginning family therapists. This article reports the results of ratings from the 103-member panel of experts who practice and teach Structural Family Therapy. A total of 100 competencies of Structural Family Therapy were rated in terms of importance on a 5-point Likert scale by the panel. Panelists were also given alternative responses such as “appropriate as a generic skill,”“inappropriate for beginning therapists,” and “don't understand what this means.” Rationale for the approach and results are discussed in terms of the importance of empirically based competencies for the practice of Structural Family Therapy.     

BASIC FAMILY THERAPY SKILLS, IV: TRANSGENERATIONAL THEORIES OF FAMILY THERAPY

This pape focuses on the basic skills and compentencies of transgenerational approaches to family therapy, the fourth report of a program of research surveys by the Basic Family Therapy Skills Project. In the first survey, a panel of family therapy educators listed the most critical or basic skills or compentencies of beginning family therapist with a transgenerational orientation. In the third survey, self-selected respondents rated these items according to degree of importance for beginning family therapists. Rankings of the items according to mean scores of the Likert responses indicate that transgenerational family therapy skills are founded in theory and can be identified behaviorally. The most important skills are those that use the self of the therapist to understand and utilize transgenerational family therapy skills for both therapist and client. Also listed are skills that many raters deemed "generic" rather than specifically related to transgenerational family therapy. Other findings and their implications for the future training of family therapists are discusses. Although the paper is intended for family therapy educators interested in their colleagues' ideas about critical skills in trans-generational family therapy, theorists and clinicians may also find it useful.     

ADVANCES IN COACHING: FAMILY THERAPY WITH ONE PERSON

This paper describes the process of "coaching" individuals in their efforts to change themselves in the context of their nuclear and parental family systems. Although this approach is regarded as one of the major modes of intervention in family therapy, the actual methods and techniques for intervention are not widely understood. Moreover, we have expanded the Bowen approach to address powerful cultural and family life cycle influences. The goal of coaching is to help clients define themselves proactively in relationship to others in their families without emotionally cutting off or giving in. Coaching begins by training clients to become observers and researchers of their own role in the family and of family patterns of behavior. Coaching then moves to help them bring their behavior more in line with their deepest beliefs, even if this means upsetting family members by disobeying family "rules."