Nurturing Nature: Exploring Ecological Self‐of‐the‐Therapist Issues

Much has been written about the systemic effects of families and culture on individual well‐being. Seldom discussed, however, are the systemic effects of our relationship with the larger ecological system in which all families and cultures are embedded. A case is made for the importance of nature in family therapy. Furthermore, before therapists can effectively address ecological issues in therapy, they need to address various ecological self‐of‐the‐therapist issues that will influence their clinical practice. A series of questions are asked to help guide therapists in this exploration, and practical suggestions for incorporating nature into MFT clinical practice, training, and research are made.     

A feminist analysis of self-help bestsellers for improving relationships: a decade review

Self-help literature is pervasive and influential in the United States. A critical analysis of self-help books would help therapists to determine their utility for the therapeutic process and assist them in making reading recommendations to clients. In this study, a content analysis was conducted of the top 11 relationship self-help books on the New York Times Bestseller List over a period of 10 years (1988-1998) to determine the degree to which these books support a feminist approach to therapy. This study yielded three major findings. First, the number of feminist books, the number of nonfeminist books, and those falling in the middle across four components of feminist family therapy are about equal. However, the second major finding was that the top-selling books are more likely to be nonfeminist than feminist. The third finding is that most best-selling self-help books appear to have become less compatible with a feminist approach to relationships over time. This analysis encourages therapists to think critically about these best-selling books; it will also allow therapists to consider this methodology as a model for critically analyzing other books that they recommend to clients or use in their own professional development.     

‘What Was I Thinking?!’ Rhetorical Questions as a Technique to Identify and Explore Impasses in Therapy

Rhetorical questions emerging spontaneously in consultations can be used as a tool for developing self‐reflexivity and exploring the therapeutic alliance in the process of therapy with couples and families. This paper presents a technique based on the enunciation of rhetorical questions, which can point to an impasse in the process of therapy and contain a key to its resolution. The technique focuses on the distinctive feature of rhetorical questions as convening a paradoxical injunction: a question not intended as a question, while uttered as such. The technique in four steps is illustrated by examples from therapy, supervision, consultation, and self‐supervision. Its focus is the interlink between the therapeutic relationship and the process of therapy and it is informed by a second‐order cybernetics approach, dialogical practice, and the systemic literature on emotion. The technique can help develop curiosity in working with families, lead to unforeseen developments, and touch on prejudices not made explicit in previous therapeutic encounters. Whether we are acting as supervisors, therapists, or clients, the creation of a ‘secure enough’ context for rhetorical questions becomes critical to allow freeform exploration.     

The Impact of Family Therapists’ Adult Attachment Styles on Their Career Choice and Approach to Therapy: An Interpretive Phenomenological Analysis

Attachment theorists have highlighted the role of the therapist in providing a ‘secure base’ for therapy. This raises the question of how therapists with insecure as well as secure attachment styles manage the integration of their personal experience and their therapeutic work. This study explored the relationship between family therapists’ adult attachment styles, influences on their career choice and their approach to therapy. Participants’ (n = 11) attachment styles were previously assessed using the self-report Experiences in Close Relationship questionnaire. Three participants were assessed as having a ‘secure’ attachment style; three were ‘preoccupied’, three ‘fearful’ and two ‘dismissing’. They were interviewed about their practice and the impact of past or current relationships on their development as therapists. Interpretive Phenomenological Analysis was used to analyse the verbatim accounts into cluster of master themes and subthemes. The analysis identified two master themes: understanding one’s self and the impact of family of origin experiences, and the integration between personal experiences and therapeutic work. There were differences in responses relating to the therapists’ attachment styles. Therapists with ‘secure’ adult attachment styles were aware of their challenges and able to utilise their experiences in their practice and respond sensitively to their clients. Conversely, those with ‘insecure’ styles have difficulties in mentalisation and in using counter-transference responses in their practice. We suggest that family therapists, social workers and others engaged in therapeutic work with families should undertake an exploration of the ‘self’ of the therapist in the context of their own family relationships and adult attachment styles as part of their training and continuing professional development.     

What's the Use of Family Therapy?

This paper, a plenary address to the Australian Family Therapy Conference, is concerned with the role of family therapy in society and the abuse of professional power. It is argued that family therapy is part of the medicalisation of marriage and the family, through which problems are defined — often inappropriately — as relationship problems and experts (therapists) are created. Aspects of professional power are identified; its pursuit is not in the interests of families, especially those with greatest needs. Proposals to tackle these obstacles are made regarding practice and training in therapy, and the management of professional power.     

Teaching and Learning Theory For Family Therapy Practice: On The Art and Craft of Balancing

As with all practice knowledges, family therapy theory sits in a complicated relationship to practice. This paper offers a set of reflections exploring challenges of teaching and learning theory for, and about, practice in family therapy. The importance of teaching particular frameworks of practice sits in tension and balance with the importance of the common factors of therapeutic change, and the inseparability of the use of self and the use of particular practice knowledge. Passion and commitment to particular ways of working is held in balance with the need for flexibility and the freedom to think independently. Discipline and focus is balanced with creativity and the room for integration. A number of balancing practices are identified in the art and craft of teaching, and the contextual issue of power and vulnerability in the teaching and learning relationship is acknowledged. Finally, the three ‘Rs’ in teaching and learning family therapy practice theory are drawn out – reflection, the recursiveness of theory and practice, and the reflexivity of self in relation to context and knowledge.     

Ethics and family therapy: the case management of family violence*

All family therapists, and especially Milan-style systemic therapists, have been trained to take a neutral stance regarding family issues, based on a circular causality model of family interaction. Therefore, when therapists deal with family violence, their ability to perceive individual responsibility for unethical behavior is weakened or suppressed. In fact, this ability is the primary tool in developing effective treatment planning in cases of family violence: The actively physically abusive man needs to be in individual and/or group therapy, not conjoint or family therapy. The ethical judgment of the therapist is what determines the limits of family therapy.     

A perfect fit: connecting family therapy skills to family business needs

The purpose of this article is to encourage family therapists to become more interested in family business practice. It does so in three ways: (a) highlighting the number of therapists already involved in family business issues; (b) showing the parallels between family business and family therapy by applying family business research findings to couples therapy; (c) discussing how family therapists already have the practice wisdom to be effective in working with family business clients. Limitations of this practice are also discussed along with suggestions for overcoming them.     

Transitions to Systemic Practice for a Clinical Psychology Trainee

This article provides an individual perspective on encounters with systemic and family therapy ideas during the transition from university training to professional practice as a Clinical Psychology Registrar. Clinical psychology training provides a solid grounding in individually focussed, cognitive and behavioural models of psychotherapy. What may be less developed on entry to practice are the knowledge, procedural skills and reflective competencies needed to understand and respond to challenges in family‐based therapy and in working within complex caregiving systems. Systemic ideas can provide important resources for facilitating these transitions. Trainees may need support not only in gaining knowledge of family therapy models, but also in making a challenging ‘epistemological shift’ (Cullin, 2014) from internalised models of psychopathology to systemic ways of thinking about problems and change. Systemic concepts and support in developing a position of ‘hospitality’ (Larner, 2003) towards competing therapeutic models can also help the trainee be more effective in complex caregiving environments. This article provides examples from my learning as well as reflections on what may help trainees make the transition to professional practice and make use of systemic ideas.     

Video Game Use as a Tool for Assessing and Intervening with Identity Formation and Social Development in Family Therapy

Because video games are becoming such an integral part of our culture, modern family therapists are more likely than ever to encounter families with members who play them. It is easy to overlook video game use in terms of its potential as a therapeutic tool, particularly if a therapist possesses only limited knowledge of the medium. Using existing literature and my experience as a lifelong gamer, I provide family therapists with a background of the major video game genres and explain how video games can aid in the assessment of factors such as identity formation and social development. I also provide a systemic case example, recommendations for practice, and a table for quick reference to highlight potential videogame‐based family therapy interventions.     

Sometimes Words Just Ain't Enough – Enhancing the Contribution of Children in Therapy through Creative Expression

The meaningful inclusion of children in family therapy is an ideal that therapists readily align with and yet struggle to implement effectively. Within a practice that relies heavily on verbal expression, young children provide a unique challenge for therapists, who require developmentally appropriate opportunities for the child to express, document, and share his or her experience in all its richness and colour. In this paper the author utilises art therapy to support greater inclusion of children in family therapy by capitalising on their creative talents and facilitating the child's visual story within the family dialogue. This can assist in the formulation and treatment of systemic issues.     

How social workers reflect in action and when and why they don’t: the possibilities and limits to reflective practice in social work

The need for professionals to use reflection to learn about and develop their practice is now a universally stated goal. In social work however there has been little research into whether and how reflection in action actually occurs and this paper explores the possibilities and limits to reflective practice by drawing on research that observed encounters between social workers and children and families as the work was being conducted in real time. The findings show that practitioners often do reflect in action by elevating their minds above the interactions they are having so that they can think critically about and adjust what they are doing. But there are times when reflection is either limited or non-existent because practitioners defend themselves against the sensory and emotional impact of the work and the high anxiety they are experiencing. Drawing on psychoanalysis and social theories of the body and senses, the paper argues for a revision of the concept of reflective practice to take account of how the self is defended. The limits to reflection must be fully recognised while seeking ways to develop the capacity of practitioners to think clearly and critically so that vital insights about service users and the helping process can occur.     

Integrative Family Therapy for Child Behavioural Problems in a Parenting Support Agency

This paper describes family therapy for behavioural problems in a parenting support agency. It discusses the literature on the effectiveness of family therapy with child behaviour problems within a community support environment. The paper presents a detailed family case study, which is discussed from an integrative family therapy framework. Narrative therapy is used as an overarching framework for integrating systemic therapy and parenting skills to help a family with a mixed cultural Aboriginal and Australian background. This allows sessions that are meaningful for the family and encourages a connection to their own resources and to their community, besides creating a safe space for a dialogue that hears and values all voices.     

ECLECTIC STRATEGIC PRACTICE: A PROCESS CONSTRUCTIVE PERSPECTIVE

The development of an integrative individual and family therapy approach has been hampered by fundamental differences in philosophy and theoretical conceptualization among approaches. Given these largely irreconcilable differences systemic framework for a technical eclecticism may represent a logical step toward a more flexible consideration of both individual and family approaches. This article will describe an extension of the strategic therapy model that enables and encourages the selective application of content and techniques from individual and family approaches. Three case examples will illustrate a process-oriented, constructivist rationale for eclectic strategic practice as well as a more collaborative and relationship-oriented perspective of strategic therapy.     

Family Social Work: The Past and the Present

SUMMARY

It is easy to blame the dysfunction of a family member on his or her behavioral patterns. I use the title, “It's the Relationship, Stupid!” not to talk down to family therapists, but to remind myself that the source of dysfunction is usually family relationships, especially the marriage relationship. This article gives several case studies for practical application of therapy techniques that focus on developing the “WE” of the family unit. One practical technique that I developed is a communication typology. The married couple (and family members) are divided into “Painters” and “Pointers.” This typology explains much of the conflict and mis-communication that leads to the breakdown of the “WE.” This article also presents dysfunction within the individual as a relationship problem and introduces the concept of the “spirit” of the individual as expressing the relationship the person has with self.     

What Novice Family Therapists Experience During a Session… A Qualitative Study of Novice Therapists' Inner Conversations During the Session

“What do novice family therapists experience during a session with a couple or family?” This is the central question in this article. A videotape‐assisted recall procedure was used to study novice family therapists’ inner conversations. The therapists' reflections were analyzed using thematic analysis. This resulted in a coding system that distinguishes four main domains: (a) reflections concerning the self; (b) reflections about the therapy process; (c) reflections on emotions about the family members; and (d) managing the session as well as own emotions. The study furthermore revealed that during a session, novice family therapists experience strong emotions, such as self‐criticism and irritation. Both emotions may encompass dangers, as well as opportunities for the therapeutic alliance and the process.