The Family Floor Plan: A Tool for Training,Assessment and Intervention in Family Therapy*

The family therapy field has produced a number of expressive modalities for use in training and therapy. The family floor plan, as a tool for training, teaches systems concepts while involving trainees in an examination of their family-of-origin. In family therapy, the floor plan can be used to assess family interaction patterns and to intervene. The floor plan tool and its applications are described, including short case vignettes.     

Coming of Age: An Individual Perspective*

This paper attempts to examine some of the broader system constraints to family therapy's ‘Coming of Age’ and to relate these constraints to more personal issues that arise for the presenter as a recently qualified family therapist. These issues and constraints are clustered around the question of hierarchy, and it is the presenter's belief that, although family therapy has much to offer as a direct service method, it has less to offer as a tool for analysing phenomena of a structural nature.     

Non-Equilibrium, Chance and Change in Family Therapy

The model of the systemic approach that we commonly use in family therapy is mainly an homeostatic model insisting essentially on negative feedback and allowing little room for amplification phenomena and for abrupt changes that may occur. Our approach, called “systemic,” is related principally to models applying in cases of processes occurring at thermodynamic equilibrium or at stationary states close to equilibrium. In those instances, stability is maintained no matter what external or internal perturbations are exerted on the system. But our practice shows that a modification limited to one part of the family system extends quickly to the whole system. How are those changes brought about? How is an open system, such as the family in which feedback loops exist, pulled away from a stationary state? It was partly to answer such questions that we started to give attention to organizational forms likely to appear away from thermodynamic equilibrium and particularly to the work done in this field by the team ofllya Prigogine. Starting with a few examples of “dissipative structures” some concepts will be introduced which seem likely to be fruitful in our field.     

Family Theory According to the Cambridge Model

The family systems theory of David Kantor and William Lehr as expressed in their book, Inside the Family, forms the foundation for the model of family therapy which is taught at the Family Institute of Cambridge. This paper is a summary of and an introduction to that theory. Their concepts of family boundaries, dimensions, typal arrangements, and the four player system are presented and discussed.     

An Educational Model of Family Consultation*

This approach to working with families under stress recognizes the family as a system interacting via communication patterns among its own members and within a larger context of peers, neighbors, school, work, and community agencies. The goal is to help the family become a support system for all its members, more capable of meeting both adult and child needs for ongoing socialization and personal growth. The model is educational in that the focus is on teaching the family to identify strengths as well as dysfunctional behavior, and to acquire some basic communication and problem-solving skills. Methods are both cognitive and experiential. The approach is useful in short-term therapy with single families or groups of families.     

Wider Perspectives in Family Mediation: An Ecosystemic Approach

All mediation processes are constrained by their theoretical frameworks. A wider ecosystemic framework extends perspectives and can open new windows on family systems, interdisciplinary connections, and links between past, present, and future that shape decisions. While showing some similarities to family therapy, ecosystemic family mediation is a discrete process with clearly defined principles and boundaries. In practice, it needs to be tailored to the needs of the particular family, with special attention to the importance of listening and talking with children who are experiencing parental separation and major changes in their lives. Family mediators help family members to manage change. Mediators need to look for change within themselves too, remaining open to new ideas and the development of their thinking and practice.     

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.     

Thinking About the Emotional Interaction of Therapist and Family

The emotional interaction of therapist and family has been difficult to explore within the field of systemic family therapy. This paper looks at ways of thinking about this process. As a starting point, I take some feelings I had with three families in the course of therapy. These are used to illustrate some concepts from analytic therapy which address the emotional interaction of therapist and family. The kind of theoretical space and guidance offered within systemic family therapy is then explored, and it seems that the Milan frame gives some space for thinking about the process but offers little guidance as to exactly how this might be done. This is a paper about practice, though it's primarily a theoretical discussion. There is no aim of establishing a ‘correct’ way of understanding the emotional interaction of therapist and family.     

上海家庭结构特征分析

目前,上海家庭结构总体呈现:夫妇核心家庭、一人户家庭明显上升;标准核心家庭明显下降;三代直系家庭维持稳定。但是,从上海户籍细分来看,外来人口家庭结构已在很大程度上影响了上海的家庭结构模式,并在一人户家庭、夫妇核心家庭、标准核心家庭、三代直系家庭等家庭结构方面与上海户籍家庭存在着巨大的差异。基于第六次人口普查数据分析,提出以下建议:外来人口家庭已成为上海家庭结构中的重要单元,面对外来人口家庭结构年轻化的特点,对教育、卫生等公共服务设施的配备要未雨绸缪;上海户籍家庭的晚婚晚育与低生育率显著,合理的生育政策将有助于家庭间的代际扶持;上海户籍三代直系家庭比例保持稳定,政府应鼓励这种代际扶持。     

The Family Movement,Bowen Theory,and Theoretical Medicine: A View from the 21st Century

Important changes have occurred in the family movement in the United States since it emerged in the mid‐1950s. Psychiatry supported the movement in its early years, but that changed as psychiatry abandoned the biopsychosocial model and adopted the biological paradigm through the 1970s. This development pushed family and other therapies to the periphery of the discipline. Medicine is dominated by the biological paradigm and cause‐and‐effect thinking. The roots of the medical model go back to Pasteur. In contrast, psychiatry in the United States had been dominated through the 20^th century by psychoanalytic thinking, which rendered the discipline a step‐child to medicine. This and other factors pushed psychiatry to get biological. The change generated a ‘failure of nerve’ in the family movement, abandoning the role of the family in schizophrenia in the face of psychiatry's assertion that all serious mental illnesses had nothing to do with the family. Other important changes separating the family movement from psychiatry occurred as well. Bowen theory is anchored in biology and evolution, but it is not a biological paradigm. Maintaining solid connections to the scientific disciplines are important for keeping the theory an open system. The recent emergence of systems biology and systems medicine could challenge psychiatry's allegiance to the biological paradigm and bring family systems theory centre stage in the discipline. These new disciplines may also arrive at a systems theory of the individual that can be integrated with family theory, powering a paradigm shift in medicine as a whole.     

Hemisphericity: Implications of research on clinical practice

A brief history of the research, findings, and conclusions on how our two cortical hemispheres function is given as are some current speculations regarding an anatomical locus for some psychological phenomena. The paper suggests that much of therapy favors the left hemispheric or sequential mode of thinking. Many therapists may not recognize in some of their clients' responses a right hemispheric or simultaneous thinking preference. Respect for such thinking as on the same intellectual and maturational level as the sequential mode is indicated. Furthermore, techniques to help such clients through the utilization of their preferred hemisphere and through fostering hemispheric cross-talk can be devised. Three cases of such clients and the techniques used in working with them are described.     

Climbing the Family Tree: Working with Genograms

The genogram is a practical and widely adopted tool for mapping families in therapy. Its use can be easily learnt and is recommended for beginners in family therapy. The genogram promotes thinking In system and transactional terms, and shifts emphasis away from individual problems to relational issues. A family system can be given a visual focus, and this often reveals patterns and connections previously unnoticed. A set of conventions for constructing genograms is suggested, with ways of elaborating on this basic frame. The applications of the genogram in joining families, in planning interventions, as a clinical communication medium, and in learning family therapy are discussed. Other types of network diagrams are briefly listed, and a clinical example of a genogram is given. Finally, limits and cautions on the use of genograms are discussed.     

Expanding Systems Thinking: Incorporating Tools from Medical Sociology into MFT Education and Research

The field of marriage and family therapy has historically focused on dynamics within family systems, and at times the role of social and cultural factors external to the family. To date, however, little scholarship has examined how therapists themselves are embedded within a mental healthcare system. The purpose of this article is to demonstrate how structural components of the mental healthcare system shape the practice of therapy. We draw from the field of medical sociology to illustrate how three dominant structures—managed care, diagnosis, and evidence‐based models—are intertwining and mutually reinforcing systems that have significant and long‐term implications for systemic therapists and researchers. We recommend incorporating a sociological understanding of such structures into MFT education and research.     

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.     

Conceptual Tools for Research on Race and Social Problems: An Overview of Dynamic Theory and Model Development

Although interpersonal, group processes and inter-group relationships are dynamic phenomena, researchers have studied these phenomena in a static manner. This article provides an overview of system dynamic modeling to bring greater attention to the importance of dynamic theoretical formulations and presents important concepts and tools that can facilitate movement in this direction. Important concepts for theory development are delineated, and various reasons why the field has a penchant for static theoretical formulations are explored. A set of tools and concepts from system dynamics is presented to guide dynamic thinking and future theory building.     

Family Phone Therapy in University Counseling and Psychological Service Centers: A Family Systems Approach

Abstract

This paper offers family phone therapy as a method for student mental health practitioners to overcome the obstacle of geographic distance between students and their families when family therapy is the treatment of choice. The issues of confidentiality, triangulation, diversionary conversation, and mixed communication, which present unique concerns when engaging in family phone therapy, are introduced and strategies to deal with them are discussed. A case example is presented to demonstrate the utility of family phone therapy in dealing with problems that students who use university mental health services can typically experience. Finally, implications of dealing with students' developmental tasks from an individual or family systems perspective are discussed.     

Towards Developing a Family Therapy for Melanesia

Our principal objective is to call the attention, primarily of Australian‐New Zealand family therapists, to the relevance and the urgency of developing, promoting and providing family and/or couple therapy in the Melanesian context. We emphasise the need to take into consideration Melanesian worldviews, values and social systems. We discuss a traditional ‘mediation‐reconciliation ritual’ model of solving family or couple conflicts, and also point to some of the immediate situations in which a family therapist could intervene. A few recommendations are also made for how the academic context could be utilised to develop Melanesian family therapy.     

Separations: A Personal Account of Bowen Family Systems Theory

This paper is a personal account of my own family of origin research. It explores the impact of separations from parents, nuclear family, and extended family through a Bowen family systems theory perspective using concepts pertaining to Bowen theory such as chronic anxiety, differentiation of self, multigenerational family process, and the emotional system. An outline of the process of doing research in ‘vivo’ with my mother as well as conversations with my supervisor are included. Theoretical differences between individual and system models are discussed. A Bowen theoretical approach to the anxiety of separations is investigated. The efficacy of engaging in family of origin work and the effects of thinking systems is examined in light of how it assisted me to view family members, family system disturbances, and clients’ emotional systems more objectively.     

Cultural Issues in Therapy: On the Fringe

This paper argues that issues of culture have occupied a fringe position in the thinking and practice of most Australian family therapists. Starting with a definition of culture as epistemology, it examines factors pertaining to government policy, demography and the experience of migration to argue the relevance of a cultural perspective in mainstream family therapy discourse. The paper then looks at two central consequences for family therapy and training — cultural oppression and maintaining the status quo — if a cultural perspective continues to be neglected. It then proposes ways that therapists can introduce a cultural perspective in their thinking and clinical work. The paper concludes with a case vignette which illustrates some of the ideas.     

The Ecological Perspective Revisited*

Family therapy inaugurated a radical change in the way many emotional and psychiatric problems are understood. ‘Systems thinking’ dictated that the individual needed to be seen within a larger systemic context if his/her behaviour was to be understood and effective intervention carried out. The logical extension of this way of thinking is to argue that the family itself must be viewed within a wider context. This perspective has appeared a number of times in the family therapy literature, particularly in the ‘ecological’ tradition. Utilising an ecological perspective can, however, lead to a new and less clearly defined role for the therapist, and there are thus good pragmatic reasons working against its adoption.