Analysis of projective identification: An object-relations approach to marital treatment

Projective identification is an important construct to both analytic and family therapy practice approaches. It is an especially useful concept in marital therapy, and can be used as the foundation for assessment and intervention. This paper provides an overview of projective identification and an illustration of its use in marital treatment.     

Care management and social work: A case study of the role of social work in hospital discharge to residential or nursing home care

The role of social work with vulnerable adults has changed markedly in many countries, including England and Wales following the 1990 NHS and Community Care Act. The basis for this paper is a small qualitative study of the social work role in helping people entering residential or nursing care in the independent sector following an emergency hospital admission in England (Phillips and Waterson 1997). This double transition is an under-researched area (Bywaters 1993; Downs and Crossan 1999). Furthermore, the literature on hospital discharge to date relates to developing policy objectives (Department of Health 1989, 1992, 1994a) or a critique of them (Pearson 1994; Cresswell 1994; Nazarko 1994) or the impact on practice, highlighting issues of inter-disciplinary cooperation (Rachman 1993; Higgins et al. 1994; Davies and Connolly 1995a; Clark et al. 1997; Healey et al. 1999). Until very recently, there has been much less about the users and carers perspective of the effects on the social work role in this area (Hardy et al. 1999; Henton et al. 1999; MacDonald 1999; Chesterman et al. 2001; Hellstrom and Hallberg 2001). The research findings review the core tasks of care management and point to a devaluing of the 'social' dimension, which had previously been the mainstay of hospital social work, and which is precisely what users and carers continue to value. Whilst this paper is written from a UK perspective, and focuses on a small study of an atypical area of work, this finding raises issues of wider interest to those concerned with the health and social care of vulnerable adults in a range of transnational contexts. It raises fundamental questions about the nature of contemporary European social work.     

Transitional relationships: Clinical observations on a form of peer parenting

Adolescents may form quasi-parental/quasi-marital couples to compensate for insufficient access to parental objects at this crucial developmental stage. These relationships constitute a form of peer parenting which can facilitate transition to adulthood. Object relations theory provides a theoretical framework for assessing and responding to critical developmental needs that these young couples present in the clinical setting. An object-relations assessment of a transitional relationship couple is presented, and treatment strategies discussed.     

Happily ever after?

Eight months after filling out questionnaires, 23 dating couples and 15 living-together couples were recontacted about their relationships. A larger percentage of dating couples had married than had living-together couples. Lower scores on couple adjustment characterized couples who later separated, compared with those who stayed together or who married. Adjustment was measured in terms of the unique configuration of relationship variables for each group. It was concluded that marriage may be a less appropriate index of couple progress in courtship than aspects of interpersonal and personal development.     

Biography Building To Insure The Future: Women's Negotiation Of Gender Relevancy In Medical School*

In this paper I focus on how women in their first year of medical school build biographies of fitness as a means of negotiating the status of peer in a male-dominated group. Their goal is to negotiate a master status and primary identity as medical student. They do this by making gender, a key characteristic, both irrelevant and relevant. I also discuss the technique of using interview data to provide a particular perspective on the medical students' situation and their use of the interview as a vehicle for identity building. I conclude that women's apparent success in maintaining identities as successful people and in negotiating barriers to the collegia! status stem both from their numbers and from using situationally appropriate vocabularies of motives to build past and future biographies of fitness.     

The South African Family in Transition: Training and Therapeutic Implications

A universal pattern of transition from the extended family to the nuclear family and beyond is proposed. Stages of transition concurrently found among South African families are detailed and examples of resultant pathology are presented. Emphasis is given to specific therapeutic dilemmas facing the South African family therapist. These include the feasibility of intervention in the extended family, the problems associated with intervention across cultural boundaries and the appropriateness of specific therapeutic goals. The current status of training is outlined and the prerequisites for effective service and training are highlighted.