Family Therapy Approach Research Articles

A review of multispousal relationships - psychosocial effects and therapy

Polygamy is defined as a marital system in which a man is married to more than one woman at the same time. This article reviews 210 articles from the literature. The aim is to place polygamy in a cultural context and suggest family therapy approaches to psychological and other stresses that may arise from these relationships. Polygamy is accepted and legally practised in many cultures worldwide. It may have both beneficial and deleterious psychosocial consequences for individuals involved in such relationships. Some of the issues arising in such multiparental families can be addressed by relational therapies, if those therapies are based on what is culturally acceptable.

For Parents Only: A Strategic Family Therapy Approach in School Counseling

Schools are excellent resources for families whose children are experiencing behavioral problems at home and at school. School counselors who have training in systems theory are situated to help families make lasting positive changes in family structure and to avoid costly interventions that may or may not be helpful. According to Selvini-Palazzoli (1986), the problems between parents and children can be addressed using a universal set of directives that immediately restore the proper authority to the parents so that the parents can, in effect, help the child give up the symptomatic behavior. This article presents a technique based on Selvini-Palazzoli’s “invariable prescription” (p. 342) for professional school counselors working with families and their acting-out children.

Working Within the Cultural Context of Chinese American Families

This article focuses on applying a novel approach to address cultural issues in working with Chinese American families. The author proposes that a Multicultural Integrative Family Therapy Approach has special applicability to working with Chinese American families. This approach emphasizes working within the family's cultural context. A brief description of some of the major Chinese American cultural characteristics is presented as well as some of the conflicts that may occur in cultural clashes between Chinese and American cultures. A case example demonstrates how these concepts can be applied in working with a Chinese American family.

How to Talk to Christian Clients About Their Spiritual Lives: Insights From Postmodern Family Therapy

Responding to literature calling for the integration of Christian spirituality and postmodern thinking, this article presents a more specific discussion of how postmodern family therapy approaches can be used to open therapy to the spiritual lives of Christian clients. In this article, postmodern family therapy approaches are described and the compatibility of postmodern family therapies and Christian thinking are examined. Finally, we see how a clinical practice based upon postmodern ideas can provide pastoral counselors with useful tools for talking with Christian clients about their spiritual lives.

Gender and Sexual Orientation in Family Therapy: Toward a Postgender approach

Abstract: We examine how the issues of gender and sexual orientation have been addressed in family therapy and identify critical issues as the field defines itself in a postmodern, inclusive era. We show how unintentional bias and creation of the category of “other” persist throughout the history of clinical practice despite a rise of interest in diversity. We suggest that family therapy approaches have been based on a view of sex‐gender that creates dichotomous categories, confounds gender and sexual orientation, and limits flexibility. A postgender approach organized around a relationship model based on equality rather than gender is advocated. Obstacles to postgender practice are identified, and guidelines for practice and challenges for the future are discussed.

Constructing a Life That Works: Part 2, An Approach to Practice

The 1st article (C. Campbell & M. Ungar, 2004) of this 2‐part exploration of postmodern approaches to family therapy and narrative approaches to career counseling explored the differences between traditional trait and factor counseling models and postmodern approaches using life narratives and social constructionism. In this 2nd article, the authors discuss 7 aspects of their practice as postmodern career counselors that ask clients to (a) know what you want, (b) know what you have, (c) know what you hear, (d) know what constrains you, (e) map your preferred story, (f) grow into your story, and (g) grow out of your story. Several case studies demonstrate the applicability of these theories to practice.

Office versus Home-Based Family Therapy for Runaway, Alcohol Abusing Adolescents

There is a dearth of research examining treatment engagement and attendance among runaway youth and their families. Such research is needed in order to inform treatment providers on factors associated with engagement and maintenance of these difficult to engage families into counseling. This study examined differential treatment attendance for alcohol abusing runaway youth residing at a local shelter. A traditional office-based family systems approach, Functional Family Therapy (FFT), was compared to a non-traditional, home-based, multisystemic family therapy approach, Ecologically Based Family Therapy (EBFT). As expected, treatment engagement and attendance was significantly higher for those assigned to EBFT (N = 37) compared to FFT (N = 40). Predictors of treatment attendance (income, family chaos, externalization problems and level of youth substance use) were examined within each treatment modality. Findings suggest that home-based (compared to office-based) treatment modalities may significantly increase treatment attendance and engagement of runaway youth and their families. Non-traditional forms of treatment may need to be considered in order to best meet the needs of highly chaotic and disorganized family systems.

Textbook of Family and Couples Therapy: Clinical Applications

Back to table of contents Previous article Next article Book Forum: TextbooksFull AccessTextbook of Family and Couples Therapy: Clinical ApplicationsSAMUEL SLIPP, M.D., SAMUEL SLIPPSearch for more papers by this author, M.D., New York, N.Y.Published Online:1 Apr 2004https://doi.org/10.1176/appi.ajp.161.4.774AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail This edited book attempts to provide a broad overview of family and couples therapy that covers the wide spectrum of theoretical approaches. Although this is laudable, it provides us with too many appetizers and an unsatisfying meal. The field of family and couples therapy is difficult to cover because, in the absence of any encompassing theoretical framework, a patchwork of conflicting theories attached to charismatic clinicians has developed. In addition, family therapy began during a period of disillusionment with established authority following World War II and the Vietnam War and relied on philosophical underpinnings without much scientific validation.Dr. Sholevar says that one can be eclectic and combine all of the family therapy approaches, which is clearly clinically incompatible. He starts this book by stating that family therapy is “an umbrella term for a number of clinical practices based on the notion that psychopathology resides in the family system rather than individuals.” This statement denying pathology in the patient reflects the perspective of many systemic family therapists. In the concluding chapter, however, he agrees with the National Alliance for the Mentally Ill that schizophrenia is a biological illness and “there is no clear evidence that some of the stressful family interactional patterns such as communication deviance, expressed emotion, and affective style predated or followed the symptomatic behavior in the schizophrenic patients.” These polarized statements contradict one another, and both are inaccurate. The long-term Finnish Adoptive Family Study of Schizophrenia by Pekka Tienari et al. (1) indicated that both a youngster’s genetic loading and a family with high communication deviance are necessary for schizophrenia to develop. We also know from neurobiology research that genes are strongly influenced by the environment; both are important.Chapter 3, “Constructing Therapy” by Scott Browning and Robert-Jay Green, mentions the work of Mara Selvini Palazzoli on systemic family therapy. At a conference in Heidelberg in the 1980s, Dr. Selvini Palazzoli stated that she would drop a bomb: that schizophrenia could be cured by the parents leaving a note on the kitchen table that they were going out. Unfortunately, the bomb exploded in her hands, destroying her credibility. No critique of this event is presented in this book. In addition, the book states that Gregory Bateson rejected the incorporation of his ideas by systemic family therapists because he remained an anthropologist. Bateson was one of my teachers, and he objected to therapists, some of whom were not trained in mental health, taking a controlling stance to effect change. There are some other areas of misinformation. Object relations family therapy was not developed in England, as stated in this book, but in the United States. I published the first book on object relations family therapy (2), and others later expanded this approach. In addition, Stephen Fleck’s name is misspelled as Flick. Finally, in chapter 32, “Family Intervention With Incest,” the editors say that the therapist should not believe patients with borderline personality concerning incest because of the patients’ cognitive distortion. Clearly, the therapist cannot discount the believability of the patient. In fact, many clinicians find that borderline personality disorder is frequently attributable to incest and consider it a posttraumatic stress disorder from childhood (2, 3).Despite these criticisms, there are many excellent chapters that are accurate and deal with their topics in depth. These include, among others, “Family Life Cycle” by Joan Zilbach, “Diagnosis of Family Relational Disorders” by David Miklowitz and John Clarkin, and “The State of Family Therapy Research: A Positive Prognosis” by John Clarkin, Daniel Carpenter, and Eric Fertuck. Unfortunately, the book lacks sufficient depth and does not fulfill its mission of providing an accurate and consistent account of family or couples therapy that is helpful to clinicians.Edited by G. Pirooz Sholevar, M.D., with Linda D. Schwoeri, Ph.D. Arlington, Va., American Psychiatric Publishing, 2003, 948 pp., $59.00.

Treatment of Adolescent Anorexia Nervosa Using Manualized Family-Based Treatment

This article reports on the treatment of an adolescent girl with anorexia nervosa using a manualized family therapy approach. The therapy used proceeds through three phases. The first phase encourages parents to take charge of refeeding their daughter while separating the illness from the patient. The second phase promotes the adolescent once again eating on her own, and the third phase aims at general adolescent issues that have been affected by anorexia nervosa. The family therapy reported on her has been shown to be effective in clinical trials and this case illustrates the basic therapeutic processes and outcomes that can be expected.

Child and Youth Care Family Support Work

SUMMARY This article describes the theoretical process and practical skills involved in a child and youth care approach to family work. The behaviors and boundary dynamics for this worker are significantly different than those envisioned in family therapy approaches, including gaining credibility by actually living with difficult youth, trusting families to know what they need, supporting families by doing useful things in the life space, having a systemic view of families, maintaining clear boundaries in an intimate environment, the use of analogue communication versus dialogue, and having an “observing ego”.

Incorporating the Family in the Cognitive-Behavioral Treatment of an African-American Female Suffering from Panic Disorder with Agoraphobia

This article highlights interpersonal aspects of panic disorder with agoraphobia (PDA) and discusses some family dynamics implicated in the creation and maintenance of panic symptomatology. A case of complex PDA is presented to demonstrate Panic Control Treatment and the integration of family therapy approaches. Treatment techniques included psycho-education, breathing retraining, cognitive restructuring, interoceptive exposure, in vivo exposure and discussion of secondary gains and family dynamics. The importance of a flexible approach to treatment of PDA using multidimensional techniques is emphasized.

Multisystemic Therapy: An Empirically Supported, Home-Based Family Therapy Approach

Multisystemic Therapy (MST) is a well-validated, evidenced-based treatment for serious clinical problems presented by adolescents and their families. Across randomized clinical trials, MST has been effective in reducing out-of-home placements, delinquent behavior, substance use, and psychiatric symptomatology compared to services currently available in the community. This article is an introduction to the MST approach and outlines key clinical features, describes the theoretical underpinnings, and discusses the empirical support for MST’s effectiveness with a variety of serious clinical issues.

Multisystemic Therapy: An Empirically Supported, Home-Based Family Therapy Approach

Multisystemic Therapy: An Empirically Supported, Home-Based Family Therapy Approach

Fundamentals of Theory and Practice Revisited; The Mutiny and the Bounty: The Place of Milan Ideas Today

The author traces the development of the Milan approach from the beginning, through the split into two teams in 1980, and subsequent developments in theory and application. He identifies possible unrecognised or undeclared influences of Milan in other family therapy approaches.

Sociopolitical activist or conversational partner? Distinguishing the position of the therapist in narrative and collaborative therapies.

In this article, we explore the similarities and differences of two contemporary family therapy approaches: narrative and collaborative therapies. These therapies are contrasted by describing positioning of the narrative practitioner as sociopolitical activist and the collaborative practitioner as conversational partner. The article begins with a brief overview of the two therapies. Subsequently, we outline their epistemological genealogies and the practice similarities that arise from the theoretical assumptions underpinning these therapies. The remainder of the article addresses the theoretical and therapeutic differences in narrative and collaborative approaches reflected in the positioning of therapist as either sociopolitical activist or conversational partner. While narrative and collaborative approaches share more similarities than differences in relation to their emphasis on the constitutive characteristics of language, focus on sociorelational contexts, and critique of singular objective truths, prominence is given to the starker contrasts in narrative and collaborative understandings of politics, power, dialogue, and discourse. It is proposed that by outlining some provocative contrasts between narrative and collaborative approaches, new conversations and generative practices will emerge in the therapy room.

Clinical Epiphanies in Marital and Family Therapy: A Practitioner's Casebook of Therapeutic Insights, Perceptions, and Breakthroughs • Divorce, Family Structure, and the Academic Success of Children • Living on the Razor's Edge: Solution-Oriented Brief Family Therapy With Self-Harming Adolescents

Clinical Epiphanies in Marital and Family Therapy: A Practitioner's Casebook of Therapeutic Insights, Perceptions, and Breakthroughs • Divorce, Family Structure, and the Academic Success of Children • Living on the Razor's Edge: Solution-Oriented Brief Family Therapy With Self-Harming Adolescents

Clinical Epiphanies in Marital and Family Therapy: A Practitioner's Casebook of Therapeutic Insights, Perceptions, and Breakthroughs ? Divorce, Family Structure, and the Academic Success of Children ? Living on the Razor's Edge: Solution-Oriented Brief Family Therapy With Self-Harming Adolescents

Clinical Epiphanies in Marital and Family Therapy: A Practitioner's Casebook of Therapeutic Insights, Perceptions, and Breakthroughs ? Divorce, Family Structure, and the Academic Success of Children ? Living on the Razor's Edge: Solution-Oriented Brief Family Therapy With Self-Harming Adolescents

Knowledge for Direct Social Work Practice: An Analysis of Trends

This article reviews selected trends in the knowledge base of direct social work practice over the past quarter century: burgeoning diversity in practice approaches; new views of the client‐practitioner relationship; the development of multilevel intervention models; the emergence of family therapy approaches; increasing focus on action, meaning, and information in client helping services; and growing attention to scientifically based practice. These trends are analyzed as products of practice movements, which experience cycles of growth, change, and decline, leaving legacies in the form of additions to the core knowledge of the profession.

Family Therapy for ADHD: Treating Children, Adolescents, and Adults

Back to table of contents Previous article Next article Book ReviewsFull AccessFamily Therapy for ADHD: Treating Children, Adolescents, and AdultsJason H. Edwards, Ph.D.Jason H. EdwardsSearch for more papers by this author, Ph.D.Published Online:1 Dec 2001https://doi.org/10.1176/appi.ps.52.12.1661-aAboutSectionsView articlePDFView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View articleAttention-deficit hyperactivity disorder (ADHD) is one of the more common presenting problems among children in psychiatric outpatient settings. Because much has already been written about the disorder, one reasonable question about any new book on the subject is whether it contributes anything new to the literature that may be helpful to clinicians. The short answer in this case is a definitive yes.The significant clinical contribution of this book lies in the emphasis it places on a developmentally informed family systems and family therapy perspective in the assessment and treatment of ADHD. The primary message of the book is that the assessment and treatment of a person with ADHD should occur in the context of the person's family system.Family Therapy for ADHD is thoughtful, readable, and clinician friendly. The clinical wisdom the authors have gleaned from many years of practice is evident in their good use of case studies to illustrate their creative ideas. The book has a strong how-to quality that is helpful to clinicians who are interested in incorporating the authors' ideas into practice.The book is well organized overall, and each of its nine chapters begins with a helpful outline of what is to follow. An introduction provides insights into various families' experiences with ADHD through case studies, and the first chapter covers background information concerning ADHD, including DSM-IV criteria, etiology, epidemiology, and comorbid disorders.Chapters 2 through 5 address assessment issues and are particularly interesting in their presentation of a family systems perspective. These chapters include discussion of the pragmatics of coordinating and collaborating with other professionals and larger systems in the evaluation process. The authors clearly articulate the intergenerational impact of ADHD on the family system. An interesting five-stage developmental family systems model for assessing child and adolescent ADHD is presented. The model integrates a family life cycle perspective in assessing ADHD symptoms and the impact they have on the child and his or her parents and siblings.The last three chapters address family systems treatment for children, adolescents, and adults, respectively. An interesting 12-session treatment model for children and a ten-session model for adolescents are presented. The models are discussed session by session, and goals for each session are clearly delineated. This book was published before the initial reports of the Multimodal Treatment Study of Children With ADHD (MTA) (1). However, there appears to be some empirical support for aspects of the authors' family systems treatment approach with children. Given what is currently known about treatment effectiveness, clinicians might consider increasing the number of sessions devoted to parent management training in the model.The final chapter addresses treatment for adults. Some useful suggestions are presented, but certainly more discussion of evaluation and treatment would be required for clinicians who intend to work with adults with ADHD. The authors may have tried to accomplish too much by including this chapter.Clinicians might obtain the most benefit by integrating the authors' family therapy approach with what we know empirically about child ADHD and adolescent ADHD. Clinicians who are less familiar with evaluation and effective treatment of ADHD might consider reading Barkley (2) and Robin (3) first, along with reports about the MTA. This is not a criticism of the book but rather an acknowledgment of its unique contributions to the literature.The family systems perspective presented in Family Therapy for ADHD enriches our current knowledge about assessment and treatment of ADHD. This very practical book is likely to be useful for mental health clinicians who work with individuals who are experiencing ADHD, particularly with children and adolescents.Dr. Edwards is associate professor of psychology and codirector of the Center for Children and Families at Frostburg State University in Frostburg, Maryland.by Craig A. Everett and Sandra Volgy Everett; New York, Guilford Press, 1999, 270 pages, $35

Family therapy with unmarried African American mothers and their adolescents.

Almost two-thirds of African American births are to unmarried mothers, and these single parents are among the most economically vulnerable in the United States. The effects of chronic stressors such as poverty can compromise the ability of these mothers to parent effectively, particularly during the developmental period of adolescence, typically a stressful phase of parenting. This article describes a multidimensional family therapy (MDFT) approach to working with African American adolescents who have drug and/or behavior problems. It is maintained that addressing the intrapersonal functioning of African American single mothers is vital if they are to re-establish the attachment bonds necessary for the maintenance of essential parental influence in the lives of their adolescents. Through systematic attention to the parent as an individual, leading to a balance between self-care and care for others, parental supervision is more easily achieved and relational impasses between parent and adolescent more equitably resolved.