Case Studies in Couple and Family Therapy: Systemic and Cognitive Perspectives

Abstract

Case Studies in Couple and Family Therapy: Systemic and Cognitive Perspectives Frank M. Dattilio (Ed.). New York: Guilford Press (www.guilford.com). 1998, 486 pp., $44.00 (hardcover). In the contemporary social sciences it is becoming well recognized that individuals actively construct the meaning of their experiences. From this postmodern perspective, distinguishing perception from interpretation becomes largely irrelevant. Causality is no longer conceived as a linear process (e.g., objective reality impinging upon subjective interpretation), but as a circular one characterized by continual feedback and interplay among the various components of complex systems. In psychotherapy, these ideas have encouraged movement away from intrapsychic models of psychopathology to those conceptualizing the individual as acting and reacting within these multiple dynamic systems. The greatest elaboration of the systems perspective has occurred in the realm of couple and family therapy, where therapists have harnessed the power of these assumptions to develop creative and powerful clinical interventions. For many cognitive-behavioral therapists, most of whom were raised on assumptions of linear causality (e.g., behavioral contingencies, cognitive distortions leading to maladaptive responses) and logical positivism (e.g., examination of objective evidence to refute distorted thoughts), the systems perspective can seem somewhat alien. On the other hand, systemic therapists may be unfamiliar with some of the directive and empirically validated therapeutic tools which are second nature to cognitive-behavioral therapists. Fortunately for practitioners of both perspectives, there now exists the informative and accessible Case Studies in Couple and Family Therapy: Systemic and Cognitive Perspectives, edited by Frank Dattilio. This volume features contributions by leading clinicians representing diverse perspectives on the treatment of couples and families, including such recognizable names as Salvador Minuchin, Norman Epstein, Donald Baucom, James Keim, David Keith, Michael Hoyt, Luciano L'Abate, Karl Tomm, and Fred Sander. Together, Dattilio and these authors have thoughtfully chosen cases that illustrate areas of intersection between the cognitive-behavioral and systemic perspectives, highlighting the possibilities for fruitful cross-pollination between the models. This is consonant with Dattilio's stated intent to facilitate theoretical integration across approaches. The case study approach is an especially congenial method of accomplishing this task. By deemphasizing theory and presenting what couple and family therapists actually do in sessions, the reader gains a wealth of compelling and useful techniques to add to his or her therapeutic arsenal. Moreover, the authors endeavor to explain how specific interventions arise from seasoned clinical intuition. Thus, the reader also is treated to (and may be somewhat awed by) the true artistry and boldness of these clinicians. What distinguishes this book from other volumes on couple and family therapy is the ongoing dialogue between the editor, representing cognitive-behavioral therapy, and the authors representing alternative theoretical perspectives. Throughout each chapter, Dattilio raises thoughtful questions, draws comparisons to a standard cognitive-behavioral approach, and provides a rationale for alternative interventions. These editorial comments appear italicized and indented within the body of each chapter's text, allowing the reader to consider alternative interventions at key decision points in the case. At the end of each chapter the authors are given an opportunity to respond to Dattilio's comments. To the credit of both the chapter authors and editor, these exchanges remain civil and constructive even where irreconcilable differences occur. This dialogic approach permits the reader to reflect on the comparative advantages and, in many cases, the compatibility, of cognitive-behavioral and systemic approaches and to consider the value of technical integration. …