BASIC FAMILY THERAPY SKILLS,II: STRUCTURAL FAMILY THERAPY1

The Basic Family Therapy Skills Project has yielded empirically derived skills important for beginning family therapists. This article reports the results of ratings from the 103-member panel of experts who practice and teach Structural Family Therapy. A total of 100 competencies of Structural Family Therapy were rated in terms of importance on a 5-point Likert scale by the panel. Panelists were also given alternative responses such as “appropriate as a generic skill,”“inappropriate for beginning therapists,” and “don't understand what this means.” Rationale for the approach and results are discussed in terms of the importance of empirically based competencies for the practice of Structural Family Therapy.     

BASIC FAMILY THERAPY SKILLS, IV: TRANSGENERATIONAL THEORIES OF FAMILY THERAPY

This pape focuses on the basic skills and compentencies of transgenerational approaches to family therapy, the fourth report of a program of research surveys by the Basic Family Therapy Skills Project. In the first survey, a panel of family therapy educators listed the most critical or basic skills or compentencies of beginning family therapist with a transgenerational orientation. In the third survey, self-selected respondents rated these items according to degree of importance for beginning family therapists. Rankings of the items according to mean scores of the Likert responses indicate that transgenerational family therapy skills are founded in theory and can be identified behaviorally. The most important skills are those that use the self of the therapist to understand and utilize transgenerational family therapy skills for both therapist and client. Also listed are skills that many raters deemed "generic" rather than specifically related to transgenerational family therapy. Other findings and their implications for the future training of family therapists are discusses. Although the paper is intended for family therapy educators interested in their colleagues' ideas about critical skills in trans-generational family therapy, theorists and clinicians may also find it useful.     

A REFLECTING TEAM APPROACH TO FAMILY THERAPY: A DELPHI STUDY

Due to different conceptualizations and unclear theoretical guidelines, a reflecting team approach to family therapy has lacked conceptual and practical clarity. The purpose of this exploratory study was to outline the theory and practice of a reflecting team approach to family therapy. A Delphi technique was employed for panelists to consider the theoretical assumptions, techniques, how change occurs, major goals, when to use, and contraindications of a reflecting team approach. Analysis of data revealed where consensus was reached and a profile was formed to aid in further clarifying this approach.     

ON THE VALUE OF INTEGRATING APPROACHES TO FAMILY THERAPY

This paper considers the strengths and weaknesses of an integrative approach to family therapy. An integrative approach can explain a broad range of human behavior, can shape intervention strategy in a manner appropriate to each case, can allow for treatment of a broad client population, can combine the strengths of each of the specific approaches, can promote objectivity in selection of strategies of change, and can permit easy expansion of the repertoire of techniques. The potential pitfalls basically revolve around the complexity of practice; in particular, the possibility of inconsistency of approach. With care, these pitfalls can be avoided. Integration is viewed as a viable alternative to school-specific practice in family therapy.     

ON THE VALUE OF INTEGRATING APPROACHES TO FAMILY THERAPY

This paper considers the strengths and weaknesses of an integrative approach to family therapy. An integrative approach can explain a broad range of human behavior, can shape intervention strategy in a manner appropriate to each case, can allow for treatment of a broad client population, can combine the strengths of each of the specific approaches, can promote objectivity in selection of strategies of change, and can permit easy expansion of the repertoire of techniques. The potential pitfalls basically revolve around the complexity of practice; in particular, the possibility of inconsistency of approach. With care, these pitfalls can be avoided. Integration is viewed as a viable alternative to school-specific practice in family therapy.     

SYSTEMS CONSULTATION AND HEAD START: AN ALTERNATIVE TO TRADITIONAL FAMILY THERAPY

As Marriage and Family Therapists (MFTs) enter Head Start programs, systems consultation emerges as a viable alternative to providing therapy to enrolled children and families. As systems consultants, family therapists can offer organizational consultation, training, and support to Head Start staff, classroom interventions, and direct work with families. This article describes a multidimensional model for providing comprehensive mental health consultation to Head Start programs. It explores the skills necessary for MFTs to work effectively as systems consultants. Finally, recommendations are made for applying the model in both university and private settings.     

FAMILY RESEARCH AND FAMILY THERAPY: A REUNION?*

This decade is witnessing the re-establishment of research in family therapy as an intrinsic component of the field. It is instructive to recall that family therapy actually had its most significant beginnings in the context of family research in the 1950s and that, three decades ago, family therapy and family research were fundamentally fused. In this paper, several of the most important forms of recent and current family research and family therapy research that are important to clinicians are identified, and it is suggested that this reunion of clinical and research interests signifies a new phase in the growth of the family therapy field.     

EXPOSURE TO MARITAL AND FAMILY THERAPY IN MEDICAL SCHOOL: A STUDENT PERSPECTIVE

Most marital and family therapists, both medically and nonmedically trained, regularly interact with physicians on a professional basis. Though some physicians receive specific training in marital and family therapy in their postgraduate residency programs, (notably those in psychiatry and family medicine), for many, the only academic exposure they receive to this field comes during a 6- to 10-week clinical clerkship in psychiatry during their third or fourth year of medical school. No study could be located which examined marital and family therapy training in undergraduate medical education. The purpose of this study was to gain a better understanding of the level of marital and family therapy training in medical school and to provide information concerning physicians who are not family therapists, and how much knowledge about the field they can be expected to have.     

THREE APPROACHES TO FAMILY THERAPY: A STUDY OF CONVERGENCE AND DIVERGENCE*

The literature on professional development suggests that the process of segmentation or specialization within a profession logically accompanies the aggregation, dissemination and application of new and expanding bodies of knowledge. The present study empirically examines the extent and dimensions of this process of segmentation within the family therapy movement by comparing the belief and action systems of 1000 experienced family therapists oriented to one of three major models of family therapy. Two theses are suggested which may explain the findings depicting a unique patterning of similarities and differences among the three models; each implying different directives and implications for the continued growth of the interdisciplinary practice of family therapy.     

SNARES IN FAMILY THERAPY

Telephone calls after therapy sessions, concurrent individual treatment of family members, the offer of secret revelations, and the use of psychoactive drugs all involve issues and events that can be insidious to effective family therapy. Various tactics are presented which not only succeed in controlling these incidents, but which also use them as important occasions for therapeutic intervention within the model of family therapy developed by Selvini Palazzoli and her colleagues in Milan.     

THE EFFICACY AND EFFECTIVENESS OF MARITAL AND FAMILY THERAPY: A PERSPECTIVE FROM META-ANALYSIS

This article reviews the major findings from a multiproject meta-analysis of the effects of marital and family therapy (MFT). Across 163 randomized trials, MFT demonstrates moderate, statistically significant, and often clinically significant effects. No orientation is yet demonstrably superior to any other, nor is MFT superior to individual therapy. Cost effectiveness information is scant in these 163 studies, but supportive. Randomized experiments yield very different answers from nonrandomized experimental studies of the effects of MFT, calling into question whether we should mix the two in reviews. We have also found several new differences in the ways that marital therapy (MT) and family therapy (FT) studies are conducted, making them harder to compare. Finally, important questions still exist about whether any psychotherapy, including MFT, yet has sufficient information about how well research generalizes to everyday clinical practice.     

THE USE OF INTERACTIVE VIDEO TO DEMONSTRATE DIFFERENTIAL APPROACHES TO MARITAL AND FAMILY THERAPY

This article outlines the development of an interactive video system designed to demonstrate differential approaches to family therapy using identical therapy situations. The primary purpose of the project is to resolve some of the confusion many novice family therapists experience while being exposed to the numerous family therapy approaches. Technical aspects of the interactive video system are also outlined.     

THE USE OF HISTORY IN FAMILY THERAPY: A BRIEF REJOINDER TO SLUZKI*

The use of history by psychodynamically oriented family therapists is often misunderstood. In place of a traditional “lifting of repression” paradigm, contemporary psychodynamic family clinicians emphasize intervening in the transmission of emotional patterning over generations in families. This model has both diagnostic and therapeutic utility for family therapists. While differences exist between this model and “systems” approaches, it is argued that integration of the two is both possible and desirable.     

AGAINST THE GRAIN: DECENTERING FAMILY THERAPY

This paper is an interpretive polemic. It has two aims: (a) to clarify the concept of "system" as it is employed in family therapy, and, by doing so, to undermine and call into question the practice that follows from, or is contained within, a systemic perspective,¹ (b) it will offer several suggestions towards the development of an alternative perspective which preserves the idea of system in a social network/diachronic framework. With respect to the first aim, an argument will be made that there are severe and insurmountable problems in attempting to maintain a systemic perspective, that the methodology of analysis is fatally flawed, and that the results of analysis imprisons the therapist in a framework, which though extremely powerful interpersonally, must be rejected as overly authoritarian and overly restrictive in the range of perceptions of social situations allowed. A position will be adopted advocating a move of decentering family therapy to a more peripheral space within a social network perspective. What immediately follows is a redefinition and repunctuation of what can only be considered as a highly problematic paradigm.     

AN EXPERIENTIAL APPROACH TO FAMILY-OF-ORIGIN WORK WITH MARITAL AND FAMILY THERAPY TRAINEES

An experiential approach to family-of-origin work with marital and family therapy students is offered as a complement to didactic study. Recommendations are made for structuring courses to include family-of-origin work without blurring the roles of instructor and therapist.     

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.