A "READER'S THEATER" INTERVENTION TO MANAGING GRIEF: POSTTHERAPY REFLECTIONS BY A FAMILY AND CLINICAL TEAM

The sudden and accidental death of a child can be one of the most devastating events in the life of a family. This paper describes one couple's reflections of their grief and mourning following the death of their adolescent son as well as the clinical team's reflections of therapy. The uniqueness of this paper is that it offers a "reader's theater" intervention that enabled further change to occur. The clinical team used a belief model, emphasizing that altering constraining beliefs is at the heart of healing from such tragedies as sudden death (Wright, Watson, & Bell, 1996). This approach is operationalized through therapeutic conversations between family members, clinician, and clinical team. Interventions such as reflecting teams, therapeutic letters, and "homework tasks" were used to modify or challenge constraining beliefs of both the family members and the clinical team members. However, the intent to co-author a paper with this couple provided the serendipity intervention of a "reader's theater" that further served to identify, affirm, and solidify facilitating beliefs.     

Action-oriented evaluation of an in-home family therapy program for families at risk for foster care placement

The purpose of this study was to conduct an action-oriented evaluation of an in-home family therapy program serving families deemed at risk for the placement of children in foster care. In this study, feedback was solicited from both clients and therapists. Results indicate "duality" associated with several aspects of in-home family therapy, including the opportunity to observe families in their own homes versus the vulnerability some families feel when therapy is conducted in-home; therapists suggesting that sufficient training is required for in-home family therapy to be effective versus clients' opinions that therapists' lived experiences are more relevant; and the importance of the therapeutic alliance versus feelings of abandonment upon termination. Implications for researchers and practitioners are discussed.     

Live Consultation Without A One-Way Screen†

This article is about a method of teamwork in which both the therapist and the consultant are present in the same room as the family. It distinguishes between the therapeutic team of consultant and therapist and the therapeutic system of consultant, therapist and family. It outlines some particular advantages and disadvantages which are present when working in the same room as the family and emphasises the importance of the careful preparation and maintenance of the therapeutic team if its creative potential for the family is to be fulfilled.     

Therapists' prototypical assessment of domestic violence situations

Prototypical perceptions by therapists have the potential to influence the therapeutic process of assessment. The purpose of this study is to begin to develop an understanding of how prototypes might affect marriage and family therapists' assessments of domestic violence situations. Participants evaluated one of three domestic violence scenarios that were identical in dynamics but different in terms of sexual orientation of the couple (i.e., heterosexual, gay, or lesbian). The most significant finding was that initial assessments of victim and perpetrator identification and power attribution differed depending on the sexual orientation of the couple. The "man as perpetrator, woman as victim" prototypical paradigm for heterosexual domestic violence emerged. In the same-sex scenarios, often "both" partners were perceived to be indicated both as victim and perpetrator.     

THE FAMILY FIRO MODEL: A MODEST PROPOSAL FOR ORGANIZING FAMILY TREATMENT

This paper presents a model for organizing family issues and family treatment. Schutz's FIRO model is offered as a framework for organizing family issues into inclusion, control and affection categories. Following Schutz's theory of group development, we propose that inclusion, control and affection constitute a logical hierarchy of core issues to be dealt with in treating multiproblem families-inclusion first, then control, and then affection (intimacy). Furthermore, we propose that the FIRO model can be used to organize theories of family therapy. We attempt to demonstrate that different family therapies are best suited for one of the three core issues of family interaction. We advocate an "intelligent eclecticism" based on the premise that when an issue is appropriately matched with a therapy, therapeutic effectiveness should be enhanced. We also discuss implications of our Family FIRO model for clinical practice.     

Giving advice on advice-giving: a conversation analysis of Karl Tomm's practice

In this article we challenge a common definition of therapeutic advice as a linear, one-way accomplishment, enacted by therapists toward clients. We also offer a novel conception of advice as a dialogical "performance," to which both therapists and clients contribute. We discuss the results of a conversation analysis of a family therapy session by Karl Tomm, showing sequential practices employed by a family therapist and a family as they jointly work out common ground to set the stage for the therapist's eventual offering of advice. We discuss the results of this study in light of the literature on advice provision in various contexts.     

"THE STORY" OF A DEATH: THERAPEUTIC CONSIDERATIONS WITH BEREAVED FAMILIES

Facilitating and listening to bereaved families tell "The Story" of their loss is an important component of therapeutic work with bereaved families. Following a discussion of the general functions of stories, the authors use a variety of case examples to illustrate how "The Story" can be used as an assessment device, as an initial intervention, and as a gauge of the progress of treatment. Family stories of loss are conceptualized as constructions, and the emphasis is on how individual and family context affect and are affected by these stories. Throughout the paper, particular attention is paid to ways stories canbe useful for children in families.     

RUNAWAYS: JURISDICTION, DYNAMICS, AND TREATMENT

New research indicates more clearly than ever that running away from home is indeed a family affair. Understood as such, the implications for society's jurisdictional response and for effective treatment planning are deep and far-reaching. The "status offender" legal jurisdiction over runaways needs to be changed and new alternatives for dealing with runaways and their families developed. The planning and implementation of these alternatives need to be informed with the perspectives of a family therapeutic approach sensitive to the intergenerational forces of loyalty, legacy, and trust operating within families.     

Juvenile anorexia nervosa: family therapy's natural niche

Juvenile Anorexia Nervosa (AN) is a severe problem both in terms of presenting symptomatology and its tendency toward chronicity. Researchers have consistently shown that family-based approaches are superior to individual approaches for the treatment of juvenile AN. This article addresses the capacity deficit of trained family therapists to treat this disease. The author reviews the effectiveness of Structural Family Therapy as a treatment of juvenile AN and the essential concepts and skills required by the family therapist to treat this disorder. The concepts of therapeutic crisis induction, enactment, and therapeutic intensity are discussed in detail. Recommendations are made for future research.     

A place for marriage and family services in employee assistance programs (EAPs): a survey of EAP client problems and needs

Marriage and family services have not been widely recognized as part of employee assistance programs (EAP), although family and relational problems are widely cited as sources of problems on the job. EAP clients (N = 800, 97% self-referred) indicated how much family, psychological/emotional, drug, alcohol, employment-related, legal, and medical problems troubled them and the need for services in each area. Psychological/emotional (66%) and family (65%) problem areas frequently were rated "considerable" or "extreme." Both areas were rated as "considerable" or "extreme" by 48.6% of participants. In view of the evidence that marriage and family services can be effective with both family and psychological/emotional problems, professionals who are competent to provide such services have much to offer EAP programs.     

Resolving Conflicts in Family Distance Regulation: An Integrative Approach

An approach to family therapy is described in which the conceptual formulation provides a framework for integrating many techniques into a coherent whole. Conflicts in distance regulation, and the "too far/too close" family systems in particular are described to illustrate how the authors conceptualize one form of family dysfunction, and how this formulation generates a set of therapeutic tasks aimed at recalibrating distance boundaries. Teaching practices congruent with the therapy are outlined.     

Compassion fatigue in marriage and family therapy: implications for therapists and clients

Given that marriage and family therapists are exposed to a wide range of circumstances that leave them uniquely vulnerable to experiencing compassion fatigue, it is important to examine the stresses and hazards they face and what those consequences mean for both themselves and clients. It is essential that they identify how compassion fatigue negatively affects the therapeutic relationship and overall treatment outcome as well as that of the personal life of the family therapist. The marriage and family therapist is responsible and ethically obligated to identify and implement ways in which he or she can prevent and remedy compassion fatigue.     

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.     

ARE GOALS AND TOPICS INFLUENCED BY GENDER AND MODALITY IN THE INITIAL MARRIAGE AND FAMILY THERAPY SESSION?

Establishment of a goal is crucial to therapy, but identification of therapeutic goals may be difficult in conjoint therapy because each participant may identify a different problem. We examined the influence of gender on ability to successfully introduce therapeutic topics in marital and family therapy by conducting two studies. The first study evaluates the ability of therapists to identify therapeutic goals that matched goals prioritized by both women and men clients on pretherapy questionnaires. The second study examines the process of initial therapy sessions to see whether gender influences a client's ability to introduce a therapeutic topic. Results suggest that therapeutic topic is influenced by the interaction of gender and treatment modality. Specifically, therapists were better able to match women's pretherapy stated goals in marital therapy than family therapy, men were more successful at introducing topics in family therapy, and women were more successful at introducing topics in marital therapy.     

Family therapy as a dialogue of living persons: a perspective inspired by Bakhtin, Voloshinov, and Shotter

There are not a lot of conceptual tools that can help a family therapy teacher to talk and teach about the importance of the therapeutic relationship in family therapy practice. The idea that family therapy can be conceived as a dialogue might offer a fresh and promising perspective. Mainly inspired by the work of Bakhtin, Voloshinov, and Shotter, the author considers if the concept of dialogue can help us to talk about something that is there all the time in our family therapeutic practices, although sometimes unnoticed, and that is hard to talk about because we lack the necessary conceptual tools. When we choose to conceptualize family therapy as dialogue, the focus of the therapist is not primarily on data collection, information processing or problem analysis. The therapist is not primarily concerned with knowing, or with not-knowing. Instead, the focus is on the idea that first and foremost therapy is a meeting of living persons, searching to find ways to share life together for a while. Clinical vignettes that feature children's drawings in family therapy are used as illustrations.     

The Family Outreach Model: Tools for Engaging and Working With Families in Distress

The purpose of this article is to present a family intervention model to family service providers that builds on previous research in areas of social support and family problem solving. The Family Outreach Model provides a set of strategies for engaging and working with families in five phases of family coping at different points in time in the family's life. The strategies reflect intentional choices by family service providers about both collaborative and directive styles of therapeutic alliance and highlights ways to determine which style best fits with what specific families want and need, depending on the manner of family coping that it is using. Implications for programs and public policy are presented.     

THE CONSEQUENCES OF CARING:

Sociologists of emotion have examined the ways that workers are required to manage their emotions on the job, while studies of family emotion work reveal the effort involved in providing emotional support at home. Analyzing data collected from married or cohabiting women hospital workers, we examine the relations between women's job and family emotion work and the effects of both on women's job-related well-being. Consistent with "scarcity" views of women's emotional energy, we find that performance of family emotion work has negative consequences for women's job-related well-being. Consistent with "expansion" perspectives, however, women who perform some emotional labor on the job are more likely than other women to perform family emotion work. Our findings support a view that incorporates elements of both scarcity and expansion perspectives. We conclude that the job-related well-being of women hospital workers is less influenced by performance of emotional labor at work than it is by women's and their partners' involvement in family emotion work.     

A FAMILY SYSTEMS APPROACH TO CRISIS REACTIONS IN COLLEGE STUDENTS

This article presents a systemic orientation to the conceptualization and treatment of crisis reactions in college students. Crisis reactions are explained as an expression of and a "solution" to the dilemma of feeling the need to both achieve for, and remain overinvolved with, the family system. It is proposed that this dilemma occurs in the context of enmeshed systems in which unfulfilled aspirations from prior generations are transmitted to the student in crisis. Based on this conceptualization, a treatment approach that incorporates the use of strategic and structural interventions within a predominantly family of origin framework is provided.     

Female same-sex families in the dialectics of marginality and conformity

The article discusses the continuum between the personal and public roles of families, where two women parent together in Slovenia, against the background of the current marginal position of same-sex families in regard to rights and symbolic status, in claiming the position of same-sex parenting in the context of family models as well as in the lesbian, gay, bisexual, and transgender (LGBT) movement agendas. It briefly outlines the situation in Slovenia in regard to homosexuality, and then moves to discussing the outcomes of the processes and experiences of lesbian mothers that are transgressing the borders of parental and homosexual identities. These outcomes are: "justifying" and demonstrating the "appropriateness" of family life in non-heteronormative families, constructing strategies for claiming a joint parental identity, and building a sense of belonging by forming a community that is both homosexual and parental. The article draws extensively on the lived (motherhood) experiences and stories of families where parents are two female partners and reads them as negotiating a constantly shifting place between a marginal status in the broader society and a conformist character in the perspective of their non-normative sexuality. In the article, it is recognized that same-sex families in Slovenia are entering the political agenda and are thus involved in transforming both contexts-the family and homosexual identities.     

GROWTH BEHIND THE MIRROR:, THE FAMILY THERAPY CONSORTIUM'S GROUP PROCESS

An earlier paper (Wendorf, 1984) presented the pragmatic aspects and theoretical model of The Family Therapy Consortium, a group set up to provide supervision and continuing education in family therapy. The emphasis was on the development of each individual therapist's competency, the isomorphic relationship between the supervisor, group, therapist, and family levels of the therapeutic system, and the legitimacy of the term "peer supervision." Beginning under the leadership of an expert supervisor hired from outside the group, the Family Therapy Consortium has developed into a peer supervision group with a "floating," rather than fixed, supervisory hierarchy. The present paper charts this development and explores the peer supervision process as it currently works in the Consortium. The focus is on the growth of the individual behind the mirror as therapist, person, leader and group member, and on the growth of the group as a "mature sibling subsystem" no longer in need of outside supervision. Individual and group development are seen as complementary aspects of the same growth process.