TRAINING THE PERSON OF THE THERAPIST IN STRUCTURAL FAMILY THERAPY

Structural Family Therapy needs a training model that integrates the existential, human mutuality of the therapeutic relationship with its technical elements. This paper offers a theoretical foundation for training structural family therapists in the use of self, discusses a model for training, and gives a case example illustrating personal training in a clinical context.     

DEVELOPING AN IDENTITY AS A FEMINIST FAMILY THERAPIST: IMPLICATIONS FOR TRAINING

Although feminists have profoundly influenced the field of family therapy, little has been written about the process by which these women came to identify themselves as feminist family therapists. This article reports the results of a qualitative research study that explored that process and suggests a model of feminist family therapy identity development. Implications for training programs are reveived.     

THE INTERPERSONAL CONTEXT OF OBJECT RELATIONS: IMPLICATIONS FOR FAMILY THERAPY*

Psychodynamic theory and family systems theories have come to represent competing orientations in the understanding of human behavior. This paper extends the quest for an integration of these perspectives. This is done by mapping ideas from one orientation onto constructs from the other. Case examples illustrate the ideas and demonstrate how inner dynamics and interactional behavior dovetail to create systemic and personal crises. Clinical implications highlight the need (a) for psychodynamic therapists to recognize the contextual forces that activate personality structures and (b) for systems therapists to recognize the idiosyncratic meanings of interactional behaviors.     

THINKING LIKE A FAMILY THERAPIST: A MODEL FOR INTEGRATING THE THEORIES AND METHODS OF FAMILY THERAPY*

We present a classification system which presumes that information about families can be seen from three different perspectives (historical, interactional, and existential) and that treatment proceeds from three approaches (understanding, transformation, and identification). Using this scheme, we discuss how theories from different schools of thought are substantially overlapping, show that families may respond according to principles other than those the therapist had in mind, indicate how traditional links between certain evaluation perspectives and approaches are unnecessarily limiting, and define two current poles or modes in family therapy (the “ingenious” and the “involved”), suggesting indications for the use of each mode. Various teaching benefits of the scheme are outlined.     

QUANTIFYING THE CLINICAL ASSESSMENT OF FAMILY HEALTH

The Family Health Scale is an instrument designed to quantify the quality of family functioning from the perspective of an external clinical observer. Rating may be based on whatever information is available on the family but, ideally, should be derived from a valid standardized method of direct observation like the Family Task Interview (Kinston and Loader, 1986). Clinical judgement must be exercised in rating, and new methods to enhance its quality have been devised. The scale may be used with nonlabelled, as well as psychiatrically labelled, families. The FHS has demonstrated consistently high inter-rater agreement, and test-retest reliability. Evidence is also offered for its validity and specificity.     

INTERVENTION PLANNING FOR THE FAMILY OF THE AUTISTIC CHILD: A MULTILEVEL ASSESSMENT OF THE FAMILY SYSTEM*

The clinician working with the family of an autistic child may need to assess the family at several levels. The first level requires an assessment of the behavioral deficits and excesses of the child. The next level examines the family in terms of their behavioral skills and the impediments that occur when they implement behavior change programs. The third level involves assessing the family unit to identify obstacles to change. While many well-functioning families may be stressed by the crises that arise in raising an autistic child, other families are predisposed to dysfunction regardless of the presence of the child.     

WHEN TRAUMA HITS HOME: PERSONAL TRAUMA AND THE FAMILY THERAPIST

This paper discusses the immediate and long-term psychosocial consequences of traumatic events that can affect psychotherapists, including family therapits. Traumatic events invade both work and personal life and can create both opportunities and dangers. These will be discussed from a traumatological perspective. including how traumatic reactions may affect a family therapist's work.     

THE POLITICS OF FUNCTIONAL FAMILY THERAPY: A FEMINIST CRITIQUE*

This paper examines the political processes inherent in Functional Family Therapy (FFT). It argues that this model of family therapy takes a covert political stance which reinforces traditional gender roles in both family and therapist. Of particular interest are FFT's affirmation of existing interpersonal functions in the family, as well as suggested therapist use of self. The implications of this stance are discussed, as well as recommendations for change.     

THE ROLE OF TIME FRAME IN THE ASSESSMENT OF FAMILY FUNCTIONING

The purpose of this study was to evaluate how the stated time frame of family questionnaires can influence the individual's report of family events and relationships. Three whole-family assessment procedures were administered to a large sample of intact families under two conditions—when the respondent was asked to describe his/her family "in general" and "during the past week". Major findings indicated that (a) reports of family relationships reflected the same overall evaluation regardless of time frame, (b) the number or degree of positive endorsements was greater on the "in general" than the "past week" format, and (c) the impact of time frame varied greatly as a function of instrument. Explanations and implications of these findings are discussed.     

THE McMASTER FAMILY ASSESSMENT DEVICE*

This paper describes the McMaster Family Assessment Device (FAD), a newly developed questionnaire designed to evaluate families according to the McMaster Model of Family Functioning. The FAD is made up of seven scales which measure Problem Solving, Communication, Roles, Affective Responsiveness, Affective Involvement, Behavior Control and General Functioning. The paper describes the procedures used to develop the FAD and presents scale means and scale reliabilities from a sample of 503 individuals.     

THE CLIENT'S INTERVIEW OF THE THERAPIST

This paper presents a framework for thinking about interactions between client and therapist systems in terms of the participants' personal explanatory systems and models of reality. The therapist's contribution to forming structures throughout the therapy is examined. The elements of a covert interview of the therapist performed by the client system are described. A model is presented for training therapists to think systemically about client/therapist fit in the context of the client's interview. A case presentation illustrates the value of the interview.     

OBESITY AND FAMILY SYSTEMS: A FAMILY FIRO APPROACH TO ASSESSMENT AND TREATMENT PLANNING1

This paper offers a model for conceptualizing interactional patterns in families presenting for treatment of obesity, and suggests a method for organizing assessment and for prioritizing treatment strategies. We use the Family FIRO Model as a framework to organize complex assessment issues, to assign priorities for which issues should be treated first, and to select appropriate treatment techniques that cut across different models of family therapy.