Family Therapy Practice Research Articles

EXAMINING THE MULTIFACETED NOTION OF ISOMORPHISM IN MARRIAGE AND FAMILY THERAPY SUPERVISION: A QUEST FOR CONCEPTUAL CLARITY

The notion of isomorphism has been recommended as a conceptual framework to guide the practice of marriage and family therapy (MFT) supervision. The term is frequently cited in the MFT training literature but is often used in different ways. A panel of MFT supervisors rated the importance and relevance to both therapy and supervision of a large pool of variables. The majority of variables were found to be equally relevant or isomorphic to the domains of MFT and MFT supervision. A qualitative interview with a small subset of the panelists suggested that the concept, to varying degrees, has influenced their work as supervisors. The implications of the results for theory development, research and supervisory practice are discussed.

Positive practice in family therapy.

Positive practice, a brief integrative approach to consultation with families, is described in this paper. A clear distinction is made between the stages of planning, assessment, therapy, and disengagement. Guidelines for progression from one stage to the next are provided. Frameworks for deciding who to invite to preliminary sessions and methods for planning and organizing lines of inquiry are incorporated into this approach to practice. A three-column model is used to construct formulations. The model allows therapists and clients to map information about the pattern of interaction around the presenting problem, beliefs that constrain family members from altering their roles in these problem-maintaining patterns, and factors that have predisposed family members to hold these beliefs. Positive practice offers methods for evolving new behavioral patterns and belief systems within sessions and for arranging homework tasks for clients between sessions. It also incorporates methods for dealing with resistance, for managing therapeutic crises, for convening individual sessions and broader network meetings, for disengaging from the consultation process, and for recontracting for further episodes of therapy. This evolving approach to practice draws on ideas from many traditions within the family therapy field and takes account of recent research relevant to the practice of family therapy.

Are trustworthiness and fairness enough? Contextual family therapy and the good family.

The moral dimension of family therapy theory and practice has received increasing attention in recent years. Boszormenyi-Nagy was among the first to see that family therapy and moral questions are inseparable. His focus on relational ethics has helped us to reappropriate individual responsibility and accountability within a systemic context. Although contextual therapy has clearly enriched the field, we argue that its emphasis on trustworthiness and fairness provides a limited view of the good in family life and leads to three related problems. First, Boszormenyi-Nagy offers a compelling ethical vision of the family and then denies that he has done so, which undermines some of his key moral claims. Second, because fairness is defined subjectively, contextual therapy may not have the resources to deal with legitimate differences in family ideals. Third, the reliance on self-interest as the primary motive for trustworthy relating appears to be self-defeating. We offer a hermeneutic perspective that takes a broader approach to the good. It places greater emphasis on the social and historical context, deals squarely with different understandings of the good in family life, and recommends an approach to resolving these differences.

Always single and single again women: a qualitative study.

What is it like to be a single woman today? Are the experiences of women who have always been single different from those who find themselves single again after having been married? How can family therapists promote the development of single women both individually and relationally? The purpose of this phenomenological, multiple-case study was to investigate perceptions of being single among heterosexual single women between the ages of 30 and 65. Nine focus group interviews and a semistructured, mailed questionnaire were used to collect the data. Constant comparative analyses were used to develop the findings. The findings were organized around the most salient theme that emerged from the analyses: single women have unresolved or unrecognized ambivalences about being single. This overarching theme was supported by three subassertions: (a) single women are aware of both the advantages and the drawbacks of being single; (b) single women are ambivalent about the reasons for their singleness; (c) although content with being single, many women simultaneously experience feelings of loss and grief. Implications for the clinical practice of family therapy and future research on single women are discussed.

Family Therapy Training Research – An Updating Review

This paper provides an update of research into the training of family therapists. Issues from the overarching contexts of adult learning, professional training and current themes in the practice of family therapy are briefly outlined. The early organization of the training research field is seen as being programme orientated, lacking a multi‐perspective approach (particularly that of the trainee) and not making use of qualitative research methods. The more recent empirical research is reviewed with these issues to the fore. The paper concludes by providing a new set of research questions, many of which can be addressed by qualitative methodologies and by calling for the research process to be an essential ingredient of training for family therapists aided by the development of the trainer/researcher role.

Review of The Reflecting Team in Action: Collaborative Practice in Family Therapy.

Originally published in Contemporary Psychology: APA Review of Books, 1997, Vol 42(1), 85. Review of The Reflecting Team in Action: Collaborative Practice in Family Therapy edited by Steven Friedman (see record 1995-98880-000). This book examines further the tenets of the reflecting team approach an

Family Therapy in Child and Adolescent Psychiatry

Family therapy has become a widely used treatment approach for emotional and behavioral problems in children and within families over the past 50 years. Mental health treatment of children and adolescents now routinely includes clinical approaches to working with family members. Family therapy has grown from models proposed and practiced by master clinicians to an integrative clinical approach tailored to specific problems and specific family circumstances. Research has demonstrated the effectiveness of family therapy approaches that are symptom-focused and developmentally oriented. The practice of child-focused family therapy involves a collaborative process including family and professionals with clearly defined roles of participation and goals for treatment.

Social Learning Family Therapy and the Treatment of Conduct Disorder in Early Childhood: Premise, Procedures and Prospects

Social learning family therapy hypotheses on the development and sustenance of conduct disorder in early childhood are presented, together with treatment approaches that use parents as the primary agents of change. Research that shows that parent training procedures hold much promise for the treatment of conduct disorder in childhood is briefly reviewed. The prospects of social learning family therapy as a treatment of children with conduct disorder could be significantly enhanced with some attention to methodological and conceptual issues in social learning family therapy research and practice.

Expanding the context of family therapy

Abstract This paper highlights and organizes ideas regarding family therapy and wider contexts. It briefly reviews the historical underpinnings of a contextual family therapy view, critiques the systems paradigm, and offers an epistemological orientation that includes wider contexts, reviews related clinical practices, and offers recommendations for future theory and practice in family therapy.

Relationship Between Work Addiction and Family Functioning

This paper examined the literature in terms of the impact of work addiction on family functioning. A theoretical model is presented which suggests that a relationship exists between work addiction, family of origin, and family functioning in adulthood. A review of the pertinent literature is presented followed by a case example and clinical implications for the practice of marriage and family therapy.

Stress and coping in the practice of family therapy: a British survey

A sample of 171 members of the Association for Family Therapy (UK) was surveyed and data obtained on their general level of experienced stress, the sources and levels of experienced stresses they encountered in their practica, and the professional and private coping strategies they used to mitigate the effects of these stressors. The results indicate that stress can be experienced in all practice contexts, with important factors in its overall configuration being personal/professional worth and agency expectation. Family therapists appear to prefer coping strategies of a more social nature and there is an ambivalent attitude towards‘therapy for therapists’.

Family Social Work Practice: Onward to TherapyandPolicy

ABSTRACT In a recent article published in the Journal of Family Social Work McNeece (1995) argued that family therapy has no interest in or relevance for social policy interventions. Through the presentation of several arguments he constructs an irreconcilable dichotomy between policy and practice, suggesting that therapeutic interventions are responsible for pulling resources away from the development of effective social policy interventions. This paper challenges the dichotomy between policy and practice and presents an alternative view concerning the relationship between social policy and family therapy. The increasing importance of family policy in family therapy is summarized and a new trend within marriage and family practice, policy as practice, is discussed. Current family practice literature and personal case examples are used to provide alternative viewpoints to three main points that were presented by McNeece concerning family therapy practice, and the therapy/policy interface. Finally, the cur...

Failure, mistakes, regret and other subjugated stories in family therapy

This paper discusses the notions of failure and mistakes in family therapy, arguing that there are insufficient accounts in the literature which reflect the untidiness and disorder of everyday practice. The idea of dominant and subjugated stories is invoked to map the influence of notions of failure upon family therapy practice. It is argued that our practice would benefit if more accounts of our work routinely included stories of failure, mistakes and regret.

Cross-Cultural Guidelines in Family Therapy Practice

This article provides a description offour cross-cultural issues and specific guidelines for dealing with these issues during the family therapy process with families from the African American, American Indian, Asian, and Hispanic communities. These issues include (a) the extended family, (b) acculturation, (c) the therapist-family race similarity versus dissimilarity in assessment and treatment, and (d) the problem of biased tests and guidelines to deal with these tests. The article also summarizes key cross-cultural variables suggested in the literature to enhance the therapist-family relationship during thefirstfamily therapy session and subsequent sessions with families from these culturally diverse groups.

Adult Attachment: Some Considerations for Family Therapy

The elaboration of attachment theory and research into the domains of adult and of mental representations of relationships has generated considerable interest amongst many mental health practitioners. The clinical implications include the potential to understand better how representations of relationships are transmitted from one generation to the next and how these are translated into parenting practices. The aim of this paper is to examine theoretical concepts associated with adult attachment and its measurement and to examine the contribution which adult attachment theory may make to the practice of family therapy. Central assumptions are that the individual cannot be understood adequately outside the context of social relationships and that the family may be understood to operate as a self regulating system.

Evaluating therapists' practices in a postmodern world: a discussion and a scheme.

The social constructionist ideas currently reshaping the practice of family therapy are also relevant for supervision. However, if, as postmodernists assert, there is no privileged, expert position, how can supervisors evaluate their trainees? This question-a most pertinent one for university-based supervision, where evaluation is necessary and constant-is addressed both theoretically and pragmatically in this article. Ethical issues are explored, and an evaluation form, developed by the authors for use in a family therapy doctoral program, is presented and discussed.

Lesbians Choosing Children

This paper examines the effects of oppression on the family building process of lesbians having children, either through birth or adoption. Family therapy theory and practices that attempt to address these dynamics by privileging the narratives of the oppressed are explored. More recent narrative based practices that emphasize the externalization of the problem as a route to increased empowerment for oppressed people are presented, along with the strengths and limitations of this type of work for lesbians forming families. Clinical examples provide a clearer sense of the lived life of lesbians and their children within a society that is generally misogynist and homophobic.

Family therapy in israel: A review of therapy done under unusual circumstances

Major issues affecting family therapy practice in Israel are discussed. Issues making family therapy in Israel unique include historical topics such as the legacy of the Holocaust, the emergence of the family therapy movement from the cradle of the kibbutz; and more recent events such as constant wars, the specter of terrorist threat, and coping with the everyday pressures of life in Israel—stress, loss, and bereavement. Future trends in family therapy in the Israeli context include the peace process and the adjustment it requires from families living in the West Bank and the Golan Heights. The advent of peace and normalization will force family therapists to grapple with issues until now not given the attention they require by a country always on the brink of war, including family violence, feminist issues and patriarchal family orientations, single-parent families, and cultural diversity.

Family therapy and clinical psychology

The results of a survey of 111 clinical psychologists in the Republic of Ireland along with some comparable data from US and UK surveys were used to address a series of questions about the link between family therapy and clinical psychology. Family therapy was not a clearly identifiable sub‐specialty within clinical psychology in Ireland. Family therapy theoretical models were used by more than a quarter of the Irish sample to conceptualize their work but by less than a tenth of US and UK respondents. In all three countries about a tenth of treatment time was devoted to the practice of family therapy. In Ireland, the use of family systems models, family assessment interviews and family therapy was more common within the child and family specialty than within the mental handicap or adult mental health clinical psychology specialties. The experience of live supervision and participation in family or couples therapy were important formative factors in the development of some clinical psychologists. Further training in systemic consultation, particularly in situations where an abuse of power has occurred, was identified in the survey as a priority area for continuing professional development. The evolving relationship between family therapy and clinical psychology is discussed in the light of these findings.

Family Therapy in the Postmodern Era

The purpose of this article is to chronicle theoretical developments and clinical trends that have emerged in profession of marriage and family therapy in recent years, an historical period so marked by transition and new ways of seeing world that popular press has dubbed it Postmodern era. On simplest level, transition from recent modern era to postmodern era is marked by a flagging societal belief in one absolute, fixed reality for all people and an increasing acknowledgment that our culture embodies an infinite variety of equally valid ways to view world (Anderson, 1990). Gone for increasing numbers of people are fixed standards that have historically divided right from wrong, decent from indecent, noble from savage. Family values, for increasing numbers of people, are less rooted in sacred principles of church and community than in a very private mix of personal, situational beliefs. The evolution of family therapy has been tremendously influenced by this postmodern environment in two ways. First of all, families are changing, partly due to increased prevalence of divorce and remarriage during last 20 years. Currently, over half of first marriages end in divorce, and projections show a full 67% of all recent first marriages may dissolve (Martin & Bumpass, 1989). Only half of all children living in U.S. will reach 18 having lived continuously with both biological parents (Furstenberg, Nord, Peterson, & Zill, 1983). Family diversity is evident in other ways as well; societal strictures have eased regarding gay and lesbian families, cohabitating families, bi-racial families, and a host of other family definitions. American society's idea of family and what constitutes family is seemingly open to new interpretation, and family therapists must recognize multiple perspectives as a matter of course. Secondly, over last decade, theories explaining how reality is processed, or how we come to know what we know, have seized imagination of family therapists and given field a rich metaphorical context for working with families in postmodern era. The most influential of these theories, second-order cybernetics, constructivism, and finally, social constructionism, have radically influenced current practice of family therapy. We will briefly discuss these theories, their common respect for language as medium of change, and then show how they are represented in four influential approaches to family therapy. POSTMODERN THEORETICAL DEVELOPMENT Second-Order Cybernetics In early to mid-1980s, family therapists began to strain against basic cybernetic model (Weiner, 1948, 1961) that had informed work in field since 1960s. The original cybernetic model, sometimes referred to as first cybernetics or Post-order cybernetics, grew out of communication engineering and computer science and offered a coherent explanation of how systems of all kinds are regulated. Defined by Sluzki (1985) as the science of patterns of organization (p. 26), cybernetic model was useful for family therapists as a way to conceptualize how families (as systems) maintain their organization. This was a technical paradigm, and families were assumed to follow a discernible and disruptible pattern of self-correction which therapist, as an outside observer, could adjust through skillful and informed intervention. During 1980s, largely through influence of Chilean biologist Humberto Maturana's work in mechanics of perception, this traditional way of thinking about role of family therapist as a social-science engineer came into serious question. Maturana, writing with cognitive scientist Francisco Varela (1980) and other thinkers such as cybernetician Heinz von Foerster (1981), strongly challenged idea of objective observer. They postulated that we process information internally, and, therefore, reality as we know it is a construction of our own private and idiosyncratic way of organizing information rather than an accurate and universally true representation of what is out there. …