Amplifying Deviations in Family Interactions: Guidelines For Trainees in Post‐Milan Family Therapy

Amplifying deviations in family interactions is a critical skill in family therapy, and one that can be implemented following the first reflecting team intervention. This paper will provide trainees with a series of practical guidelines for amplifying deviations, derived from an integration of several models of family therapy. Solution‐focused and narrative questions are employed systemically, with the aim of magnifying virtuous, rather than vicious cycles of interaction. A theoretical rationale for deviation amplifying and a brief case vignette will also be presented.     

The Evolution Of Circular Questions: Training Family Therapists

This article describes a procedure for training family therapists in the clinical application of circular questioning as developed and implemented at the Marriage and Family Therapy Clinic at the University of Iowa. A pragmatic taxonomy of circular questions is presented; instructional handouts designed to facilitate the use of these questions within the trainee's initial interviews are included.     

How and Why Do Family and Systemic Therapies Work?

My reviews of the evidence base for family therapy conducted over the past 15 years have been guided by four key questions. Does systemic therapy work? What sorts of systemic therapy work for specific problems? What processes occur in effective systemic therapy? Is systemic therapy cost‐effective? In this paper answers to these questions are given. Systemic interventions are effective for about two out of three cases. Specific models of effective systemic therapy have been developed for most common mental health problems. There are many processes shared by evidence‐based models of practice that can be incorporated into the routine practice of research‐informed family therapy. Systemic therapy is cost‐effective and in many cases leads to medical cost‐offsets. Available evidence indicates that family therapy can make a very significant contribution to alleviating suffering and making the world a better place to be.     

On Learning and Teaching Family Therapy

This paper explores some ideas about the process of learning to be a family therapist. It considers the questions: how does one learn to think like a family therapist? How is family therapy best taught? How is it learned? The author's experiences in learning and teaching are described. It is argued that family therapy differs from other approaches to therapy in some fundamental respects, and that learning to ‘be’ a family therapist is a different kind of task than learning to be a practitioner of other therapeutic approaches. The paper examines some key theoretical constructs, especially the idea of ‘levels’ of thinking, which are seen as central to both the learning and practice of family therapy.     

Theorizing in Family Studies: Discovering Process

This paper makes the case that theorizing in family studies might be different if scholars asked the types of questions that now are asked in the physical sciences. Initial efforts to move toward a more abstract explanatory level in family studies led to inventorying and verification. This paper argues that the recognition of a realm of discovery, allowing for the creative and disciplinary use of imagination and metaphor, would extend the scope and quality of questioning. To ground the argument, the paper focuses on the problematics associated with the conceptualization of process in marriages and families.     

Do Personality Changes Occur in Parents Receiving Behavioral Family Therapy?

The present outcome study is a preliminary report on whether personality changes occur in parents receiving behavioral family therapy. Behavioral techniques for changing the identified patient's presenting problem were taught to the parents and each family member was given a weekly behavioral homework assignment intended to change the dysfunctional interactions assessed in the family.
An analysis of pre and post measures using Cattell's 16PF questionnaire showed a significant decrease in the parent's self-sufficiency index, indicating increased group dependence. The mean number of sessions was 12.6. The results of this study raise questions about the nature of the personality changes occurring in family therapy of this type. Family therapists, often-times assuming the role of the "expert" for the family, may be unwittingly fostering group dependence and losses in confidence for parents receiving such family guidance.     

Family Relationships of Lesbians and Gay Men

The family lives of lesbian and gay people have been a source of controversy during the past decade. Despite prejudice and discrimination, lesbians and gay men have often succeeded in creating and sustaining family relationships. Research on same‐gender couple relationships, parent‐child relationships, and other family relationships is reviewed here. In general, the picture of lesbian and gay relationships emerging from this body of work is one of positive adjustment, even in the face of stressful conditions. Research is also beginning to address questions about individual differences among the family relationships of lesbians and gay men. Future work in this area has the potential to affect lesbian and gay lives, influence developmental and family theory, and inform public policies in the decade ahead.     

Family networks and solidarity: continuity and change

At the end of the 1960s it had become obvious that the family as an object of analysis could not be reduced to the nuclear family. During the following decades, the focus of analysis has shifted from the statistical concept of household, implicitly related to the nuclear family to ties between households and intergenerational relationships. At present, it appears that the individual would shape her entourage of parents and significant others by combining affinities, space, distance, and proximity. This opens a new way of looking at the family with new tools for observation and new definitions. This themed section includes six articles based on surveys on the family networks conducted by researchers from different European countries and Quebec, where some fundamental questions related to this new approach are discussed. It appears that family networks play an important role in supporting social change and that they reveal the crucial role played by women hidden in the household and nuclear family paradigm. Finally, the question of continuity of the generational chain is analyzed in the change-oriented baby-boom generation.     

Family Therapy's Coming of Age: Less Haste,More Speed

Responding to the question implicit in the title of the 1985 National Family Therapy Conference ‘Coming of Age’, the author argues that Australian family therapy still has a number of issues to face before it can be said to be a mature and independent adult. The paper focuses on three issues — ideology in family therapy, theory for practice, and practice itself— and raises questions about the adequacy of Australian family therapy's theoretical maturity, suggesting that there is still too much reliance on the ‘new’ and on the ‘guru’ rather than on a solid building on therapeutic experience.     

Ten Research Questions for Family Therapy

A growing evidence‐base shows that family therapy works, but many gaps in our knowledge remain about the conditions under which family therapy is effective and how it works. In this paper, ten critical research questions about family therapy that need to be addressed are considered. In short these are:

• 1 Is family therapy as effective in community settings as it is in specialist clinics?
• 2 For what problems is family therapy cost‐effective?
• 3 Does family therapy work for under‐researched problems and populations?
• 4 Do social‐constructionist and narrative approaches to family therapy work?
• 5 Can family therapy protocols be enhanced for non‐responders?
• 6 Can family therapy be combined with other psychotherapies to effectively treat specific problems?
• 7 Can family therapy be combined with pharmacotherapy to effectively treat specific problems?
• 8 What specific factors contribute to the effectiveness of family therapy with particular problems?
• 9 What common factors contribute to the effectiveness of family therapy?
• 10 What therapist and client factors contribute to the effectiveness of family therapy?

     

Integrating Reflective Practice in Family Therapy Supervision

This paper discusses how to integrate reflective practice in the family therapy supervisory relationship. This enables family therapists to think creatively, be insightful, and develop a range of perspectives regarding systemic formulation and practice. It encourages review of the past and promotes understanding in the present with the aim to improve therapists work with families in the future. Reflective practice encourages independent thinking and learning and helps therapists to develop a systemic process of critical enquiry to investigate and critique their own practice. It encourages therapists to be self‐reflective and develop confidence to think hypothetically regarding change. This allows them to pose questions for exploration, construct a new lens to conceptualise therapy and the therapeutic relationship and develop awareness of the personal as well as the professional self.     

Problematic Integration and Family Communication about Decisions at the End of Life

Making a decision on behalf of a family member at the end of life (EOL) is a highly uncertain and anxiety-ridden experience. To examine how families navigate this complex, emotionally stressful situation, Problematic Integration theory was applied as a lens for understanding EOL decision experiences managed in the context of the family. Drawing on qualitative data from interviews with 22 family members who participated in family conversations about an end-of-life decision, this study demonstrated that family members encounter multiple sources of uncertainty and divergence, including questions regarding whether or not a family member’s life is ending, what the decision should be, and who should make or participate in the decision. Family members’ stories also identified ways in which medical professionals and communication about the wishes of the patient helped family members manage problematic integration. Finally, findings revealed experiences where problematic orientations were not transformed after family members made an EOL decision.     

Longitudinal Dyad Models in Family Research

Multilevel modeling allows for the simultaneous analysis of data gathered at more than 1 unit of analysis (e.g., children nested in schools). It is often used to examine the effects of various contexts on individual differences in change. This paper promotes the application of multilevel models to longitudinal dyadic data in family research. By focusing on the dyad as context, researchers can examine within‐dyad change and begin to understand the interactive processes that constitute the relationship between partners. They can then frame questions about interdyad differences in within‐dyad change. We present several longitudinal models that researchers can use to examine the pattern of change within dyads, assess heterogeneity in change across dyads, and investigate cross‐partner effects on change. We comment on the implications of these models for family research.     

Invited Essay: Investigating Family Voices from the Margins

This essay surveys articles from the Journal of Family Communication to make the argument that our journal needs to feature more scholarship on families that heretofore have been virtually ignored or marginalized. We discuss four types of diversity to consider when exploring questions of family communication, and review three imperatives for making this argument.     

Gary Becker's Contributions to Family and Household Economics

Gary Becker's influence on the economics of the family has been pervasive. His ideas have dominated research in the economics of the family, shaping the tools we use, the questions we ask, and the answers we give. The foundational assumptions of Becker's economic approach to the family–maximizing behavior and equilibrium–as well as such primary auxiliary assumptions as household production and interdependent preferences, are now widely accepted not only by economists but also by family sociologists, demographers, and others who study the family. Yet the interesting and provocative implications of Becker's economic approach to the family do not follow from the foundational assumptions or from the primary auxiliary assumptions. Instead they depend on contested auxiliary assumptions to which neoclassical economics has no commitment and which lack empirical support. This paper discusses the crucial role of auxiliary assumptions in Becker's analysis of the family, first in the context of preferences, then in the context of household production, and finally in the context of family or household collective choice.     

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.     

Integrating Family Resilience and Family Stress Theory

The construct, family resilience, has been defined and applied very differently by those who are primarily clinical practitioners and those who are primarily researchers in the family field. In thisarticle, the family resilience perspective is integrated with conceptual definitions from family stress theory using the Family Adjustment and Adaptation Response (FAAR) Model in an effort to clarify distinctions between family resiliency as capacity and family resilience as a process. The family resilience process is discussed in terms of (a) the meaning of significant risk exposure (vs. the normal challenges of family life) and (b) the importance of making conceptual and operational distinctions between family system outcomes and family protective processes. Recommendations for future family resilience research are discussed.     

The Experiences of Couple/Marriage and Family Therapists of color: A Survey Analysis

The family therapy literature documenting the experiences of couple/marriage and family therapists (C/MFTs) of color as a group is limited. The purpose of this study was to assess the status of C/MFTs of color in their clinical training programs, clinical work, and related areas of professional challenges and opportunities. Participants (N = 113) completed a one‐time, anonymous electronic survey on SurveyMonkey consisting of demographic questions, closed‐ and open‐ended questions about their experiences. Key findings are reported related to C/MFTs of color experiences in training programs, areas of professional need, and working with racial and/or ethnic minority clients. These findings shed light on how social justice principles and practices upheld in our field are experienced from the emic perspectives of C/MFTs of color. These voices help to broaden our understanding of how we might move forward in advocating for and advancing a more culturally responsive agenda within our profession.     

A Primer for the Use of Multilevel Models in Couple and Family Therapy Research

This article serves as a primer for understanding how to use multilevel modeling (MLM) techniques in couple and family therapy outcome and process research. It outlines the use of HLM and Mplus—two of many software programs that can perform multilevel modeling—and provides an applied example of using MLM to investigate the use of postsession feedback on couple satisfaction and change, as well as the influence of trauma on the use of postsession feedback. Two graduate students in COAMFTE accredited PhD programs read the primer and provided questions to the first author that arose. Answers to these questions have been incorporated throughout the explanation of this methodological approach in hopes of addressing common stuck points for those using MLM.