ON BALANCE AND SYNERGY: FAMILY THERAPY AND QUALITATIVE RESEARCH REVISITED

Our respondents have provided though-provoking counterpoints to our original paper (Moon, Dillon, & Sprenkle, 1990). Our response is one of synthesis. First, we describe a continuum of social science inquiry paradigms as a framework for exploring the assumptions underlying our respective positions. Second, we address the key issues raised by our respondents. Third, we encourage balance in our research efforts and continuing dialogue. Finally we restate our basic thesis-that qualitative research methodology has the potential to advance the science and practice of family therapy.     

THE "INCESTUOUS FAMILY" REVISITED: A CRITICAL ANALYSIS OF FAMILY THERAPY MYTHS

From a feminist perspective, the family therapy literature concerning incest fails to perceive the patriarchal context of abusive behavior and consequently blames the victim. This paper critiques the family therapy literature by drawing on the feminist discourse concerning incest. Several pervasive myths are identified: (a) that fathers and mothers are pathologically disturbed or inadequate; (b) incest is caused by separation and loss; (c) family isolation or a rigid external boundary explains incest; and (d) incest serves a function in maintaining family organization. By analyzing the contradictions arising from these polemical positions, we propose criteria for developing an adequate clinical account of incest.     

MUSLIM FAMILIES AND FAMILY THERAPY

Muslim immigrant families living in the United States may well come to be attentiaon of mental health professionals. This article examines the applicability of the Anglo-American models of family therapy to Muslim immigrant families. The most significant difference in value systems between the Muslim and Anglo-American cultures is Muslim families' preference for greater connectedness, a less flexible and more hierarchial family structure, and an implicit communication style.
Systemic thinking, which deals with the pattern of relationships, is valid for all families regardless of cultural difference. However, the preferred directions of change for Muslim families need to be integrated into the assessment and goals for family therapy.     

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.     

AGING AND FAMILY THERAPY: PREVALENCE OF AGING ISSUES AND LATER FAMILY LIFE CONCERNS IN MARITAL AND FAMILY THERAPY LITERATURE (1986-1993)

To what extent are gerontological issues addressed in the marital and family literature? In answering this question, the authors conducted a content analysis of 873 articles published in the Journal of Marital Family Therapy, Family Process, Family Systems Medicine, and the Journal of Family Psychology during an 8-year period beginning in 1986. Only 3.2% (n = 28) of these articles contained explicit emphasis on aging issues and later life family concerns. Furthermore, there was no significant trend in the number of gerontologically focused articles published during this period. The paper describes the content of the 28 aging-focused articles, including the types of presenting problems mentioned, the relational contexts of these problems, and the types of family therapy theories represented. Included in the content analysis were the proceedings of the annual national conferences of the American Association of Marital and Family Therapy from 1986 to 1993. Only 2.3% (n = 37) of the regular conference sessions had an explicit aging focus, as did 1 of the 29 plenary sessions and 1 of the 40 Master Series® sessions. Used as a gauge of gerontological interest and awareness of late life issues, the implication of these findings is that the family therapy community is still engaged in “comming of age.”     

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.     

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.     

CYBERNETICS OF BRIEF FAMILY THERAPY

A cybernetic view of brief family therapy is presented. The article includes an historical discussion of the key ideas underlying brief family therapy, a cybernetic model of therapeutic change and a clinical case for exemplification.     

FAMILY RESEARCH AND FAMILY THERAPY: A REUNION?*

This decade is witnessing the re-establishment of research in family therapy as an intrinsic component of the field. It is instructive to recall that family therapy actually had its most significant beginnings in the context of family research in the 1950s and that, three decades ago, family therapy and family research were fundamentally fused. In this paper, several of the most important forms of recent and current family research and family therapy research that are important to clinicians are identified, and it is suggested that this reunion of clinical and research interests signifies a new phase in the growth of the family therapy field.     

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.     

TREATING ADOLESCENT DRUG ABUSE: A COMPARISON OF FAMILY SYSTEMS THERAPY, GROUP THERAPY, AND FAMILY DRUG EDUCATION

The differential effectiveness of three models of adolescent drug abuse treatment was assessed in a controlled outcome study. Family Systems Therapy (FST) was compared to Adolescent Group Therapy (AGT) and Family drug Educations (FDE). FST appeared to be more effective in stopping adolescent drug abuse than AGT or FDE, registering twice as many apparently drug-free clients than FDE and three times as many as AGT. However, a number of possible confounds make this conclusion tentative. No tretment approach was superior in altering patterns of family functioning although all three conditions improved perceived intergenerational communication.     

THE MARGINALIZATION OF FAMILY THERAPY: A HISTORICAL AND CONTINUING PROBLEM

Family therapy, and marital and family problems, are mariginalized in the larger fields of mental and physical health care, which is a misfortune both for family therapy and for other mental health professions. The early family therapists, who had multidisciplinary backgrounds, attempted toestablish a new, nondisciplinary paradigm and also tried to expand the perspectives of the more traditional mental health disciplines. More recently, family therapists have exerted greater effortsto establish marriage and family therapy as a differentiated, autonomous profession. These alternatives each involve dilemmas for the family therapy field. The positive side of becoming a distinctive profession is greater internal strength and clear professional identy; the downside is the threat of increased marginalization in rlation to the other professions, a tendency toward intellectual isolation, and hence restricted opportunities for invigorating new challenges. Family therapy now needs to develop new modes of interchange, collaboration, and selective integration with otherhealth care professions. Such interchange will be beneficial both to family therapy and to other professions.     

ARE TRUSTWORTHINESS AND FAIRNESS ENOUGH? CONTEXTUAL FAMILY THERAPY AND THE GOOD FAMILY

The moral dimension of family therapy theory and practice has received increasing attention in recent years. Boszormenyi-Nagy was among the first to see that family therapy and moral questions are inseparable. His focus on relational ethics has helped us to reappropriate individual responsibility and accountability within a systemic context. Although contextual therapy has clearly enriched the field, we argue that its emphasis on trustworthiness and fairness provides a limited view of the good in family life and leads to three related problems. First, Boszormenyi-Nagy offers a compelling ethical vision of the family and then denies that he has done so, which undermines some of his key moral claims. Second, because fairness is defined subjectively, contextual therapy may not have the resources to deal with legitimate differences in family ideals. Third, the reliance on self-interest as the primary motive for trustworthy relating appears to be self-defeating. We offer a hermeneutic perspective that takes a broader approach to the good. It places greater emphasis on the social and historical context, deals squarely with different understandings of the good in family life, and recommends an approach to resolving these differences.     

THE CORRELATES OF HEALTHY FAMILY FUNCTIONING: THE ROLE OF CONSENSUS AND CONFLICT IN THE PRACTICE OF FAMILY THERAPY

The present study explores the relative importance of individual, dyadic and triadic measures of intrafamily functioning in predicting family health. Using self-report data from 78 families, it was found that dyadic measures pertaining to marital quality and parent-child relationships were more powerful predictors than either individual measures of emotional maturity, anxiety, self-esteem or locus of control, or triadic measures of the families' hierarchical alignments. The study also found that while mothers' and fathers' assessments of intrafamily functioning were more important than the childrens' (except for the childrens' view of parent-child relationships), the parents differed in that marital quality was more important to the mothers' evaluations of the family unit while parent-child relationships were more important to the fathers'. Compositely, the findings suggest that family health is a complex multidimensional phenomenon, and that change in a particular dimension of family life may not necessarily be greeted with consensual validation or repudiation by all family members.     

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.     

BEYOND LAW AND ETHICS: AN INTERDISCIPLINARY COURSE IN FAMILY LAW AND FAMILY THERAPY

The professions of family therapy and law share many clients and areas of overlap. Law-related coursework in family therapy programs in typically limited to legal, ethical, and professional issues. However, students can also benefit from understanding other areas of overlap, such as divorce, child custody, and mediation. This article discusses the curriculum for an interdisciplinary course that educates both family therapy and law students. The course provides: (1) a substantive education about similarities and differences between the profession, how they operate as systems, and specific areas of overlap, (2) opportunities to learn clinical skills, and (3) opportunities for personal insight about skills, personality tyes, and negotiations, styles, and how these may differ between the professions.