Family Therapy Practice Research Articles

The Multiple Relationships Between Neutrality And Therapeutic Influence

The term ‘neutrality’ has multiple meanings within the literature and practice of family therapy. The first section of this paper identifies and discusses these uses. A second and more heuristic section developes linkages between neutrality and what is seen to possess professional authority. We believe these linkages tend to be obscure, only becoming accessible if the multiple, interlacing contexts within which therapists participate are examined. These contexts include: the place given to neutrality in Western culture the organisations employing therapists and how these bodies view professional neutrality, and the expectations and experience of clients in relation to professional neutrality. Because neutrality is so entwined with questions of professional effectiveness and power, the authors believe it is not possible to declare neutrality good or bad, possible or impossible. Rather the question should be: within what local circumstances, and in what particular senses of the term, can neutrality be effectively and ethically employed?

Assessing the Dynamics of Gender in Couples and Families: The Gendergram

As the field of family therapy has grappled with the issue of gender (e.g., Ault-Riche, 1986; Avis, 1986; Goldner, 1985a, 1985b, 1988; Knudson-Martin, 1994; Layton, 1984; Libow, Raskin, & Caust, 1982; Luepnitz, 1988; Sheinberg & Penn, 1991; Taffel & Masters, 1989; Taggert, 1985), the message that has emerged is clear: family therapists must be more sensitive to the ways in which gender organizes the lives of clients and therapists alike and, thus, influences the practice of marriage and family therapy. This sensitivity is crucial, given the degree to which gender crosses bounds of race, class, and place Brown, 1990, p. 13) and is interwoven with our identity as individuals (Goldner, 1985b). During recent years, family therapists have also been encouraged to pay more attention to the role of assessment in clinical practice (Bagarozzi, 1989; Filsinger, 1983; Floyd, Weinand, & Cimmarusti, 1989; Grotevant & Carlson, 1989). Although gender issues have become more integrated into clinical practice, attention to gender issues in the assessment process has been insufficient (Brown, 1990). Thus, when assessing couples and families, therapists must inquire about the role of gender in the relationship process and in the presenting problem posed by the couple or family (Goodrich, Rampage, Ellman, & Halstead, 1988). A few years ago, Hoffman (1990) indicated that gender was one of the three lenses that organized her present model of family therapy. The importance of the of gender, according to Hoffman, is that it exposes established assumptions and mores in psychological theory that have come to be taken for granted, and which are detrimental not only to women but also to men (p. 7). Hoffman advocates a position, a central tenet of which is an avoidance of making the therapist's interpretation of gender issues more valid than those of the family, while maintaining a position advocating justice for all members of the family. At the same time, a keen sensitivity to the injustices of the larger system relative to gender should motivate the therapist to include the lens of gender in all aspects of assessment and therapy (cf. Brown, 1990; Goldner, 1985b; McGoldrick, Anderson, & Walsh, 1989). It is a gender-sensitive position that has informed the development of the gendergram, a procedure for assessing and addressing issues of gender with couples and families. The gendergram targets and separates out the influence of same. and other-sex relationships on the gender role development of system members across generations and over the critical developmental transitions that highlight the characteristics of relationships over time. The focus of work with the gendergram is to make overt the assumptions about gender roles that pervade, but are typically unidentified in, family systems (Boss & Weiner, 1988). CONCEPTUAL FRAMEWORK It is our contention that the best service therapists can provide to couples and in the arena of gender is to illuminate the beliefs that influence systemic interaction. Support for this view can be drawn from the work of the Women's Project in Family Therapy: Gender themes are not merely content, which may or may not be problematic in a given family. Rather, gender is seen as an essential wellspring of all behavior, and one of the chief connecting links between a culture and its members. (Walters, Carter, Papp, & Silverstein, 1988, p. 26) Just as work with a genogram in therapy illuminates previously shadowed interactional consequences of multigenerational beliefs, traditions, and loyalties, so, too, does work with the gendergram highlight assumptions that profoundly influence relationships. Once clarified, gender influences move from being invisible forces in systemic interaction to structures that can be influenced by individual and family decision making. These distinctive core elements of family interaction, the particulars of families (Minuchin, 1988, p. …

The nomothetic-idiographic debate in family therapy.

This essay introduces the terms "nomothetic" and "idiographic" to characterize the current debate about whether the field of family therapy should accumulate and apply knowledge about patterns of adjustment that hold across different families, or whether the field should consider each family as utterly unique, and should tailor interventions solely on the basis of these unique qualities. Embedded in this debate are the arguments for and against quantitative research, disagreements about the value of clinical prediction and interobserver reliability, as well as the issue of whether therapists can rightfully claim to possess "expert knowledge." The essay begins with the personal-professional anecdote that stimulated me to explore this debate in greater depth. It continues with a brief discussion of the historical context of this debate, particularly noting the parallels between the methodological issues in personality research and those facing family therapy. The nomothetic-idiographic debate in family therapy theory, research, and practice is then described. The essay ends with the suggestion that family therapy view nomothetic and idiographic thinking as complementary, and that the field strive to develop an integrated, "idiothetic" approach to family therapy research and practice.

Laundering good ideas?: Social Work's Relationship With Family Therapy

Abstract This paper examines the relationship between social work and family therapy. To establish reference points for this examination, traditions and ideas about ‘family work’ in social work are outlined. These notions are compared with the assumptions, predominant form of practice and knowledge base of family therapy. The authors conclude from this analysis that it seems likely social work has made a considerable contribution to family therapy and that this possibility has been inadequately investigated. This absence of investigation can be related to the negative community perception of the social work profession. The probability that a poor community image of social work has become part of the subjective experience of many social workers is examined. Presuming this negative internalisation has occurred, a range of likely consequences is outlined. It is suggested that these consequences are more general than those simply pertaining to social work's relationship to family therapy.

Difference, Indifference and Differentiation

In many situations it is clearly important to value difference and foster mutual acceptance. Yet in other circumstances it is very likely that the policy of ‘valuing difference’ can translate into a rationalisation for ethical and political indifference: “Who am I to judge? Everything is equally valid”. At a second level of analysis, it is also important to recognise that there are elemental and often positive dynamics enacted through difference. In formulating a sense of identity, for example, perceptions of dissimilarity between people are often as fundamental as are positive definitions of self. In relation to identity and identity generation, differences engender differentiation between children and their families, between ‘our group’ and ‘your group’ and between family therapy and other practice methodologies. In examining the themes of indifference and differentiation I hope to re‐work a number of assumptions about “sameness” and “difference” in family therapy.

A Miracle Metaphor for Family Therapy*

This paper is a chronicle of miracle narratives in family therapy. It suggests that change is a manifold and often comes unexpectedly from life, which places it outside the control of the theory and technology of family therapy. A miracle is defined not in supernatural language, so much as a co‐incidence of events that fall together' to form a narrative for change. As poetic metaphor, miracles evoke in the family therapist an aesthetics of wonder and a ‘holy curiosity’. The miracle metaphor is illustrated by several examples from family therapy practice, and is discussed in relation to recent deconstructive theory.

Applying Delphi methodology in family therapy research

The Delphi technique, which is increasingly seen in family therapy publications, encourages the articulation of refinement in family therapy practice and theory. Combining both quantitative and qualitative methodology, this technique involves consideration of information that might otherwise have been overlooked. Due to lack of clarity on this approach, a dilemma exists in applying this research procedure in family therapy. To remedy this deterrent, this paper reviewed 11 studies and outlined use of the technique in regard to design, procedure, and sampling.

Deconstructing Race in Family Therapy

Despite the pervasive significance of race in society, attention devoted to racial issues in family therapy has been minimal. This paper explores the ways in which family therapy has relegated racial issues to a position of insignificance through a process of marginalization. Recommendations for recognizing the saliency of race within family therapy theory, practice, and training are described.

Family Therapy

This paper discusses an Irish American woman family therapist's thoughts about culture, class, race, and gender in the context of family therapy. The difference in her power position as a woman and as a white person are described. The power politics of naming are discussed. The hidden dimension of class in a "classless" society is considered as are implications for family therapy training and practice.

Primary and secondary reflection in existential family therapy

The author uses Gabriel Marcel's topology of primary and secondary thought to clarify and outline the process of reflection in Existential Family Therapy. Clinical material is used to illustrate the differences between primary and secondary reflection during the practice of Existential Family Therapy.

Feminism and Family Social Work

The intent of this paper is to explore the applicability of a feminist model for clinical social work mactice with couples and families. A brief overview of the literature relating to feminism social work is presented in preparation for the examination of clinical issues. The feminist critique of traditional family systems theory is summarized and other areas of concern in clinical work with couples and families are explored including family theory and healthy family functioning. A brief overview of feminist family therapy practice literature is provided along with a summarization of training recommendations.

Background summaries and future challenges: Family therapy in the age of isms

Different styles of practice in family therapy are increasingly distinguished by reference to theory originating from such fields as literary theory, literary criticism, philosophy, politics, art, sociology, linguistics and anthropology. The knowledge base of family therapy only minimally overlaps with these fields. Given that much of this theorising is concerned with undermining hierarchy and authority, it is an irony that much of it is itself intimidating and inviting of conformity with its own prescriptions.Family therapy theorizing is very susceptible to the influence of the latest fashions in thinking, and it is often the more outrageous, shocking and provocative ideas which win attention. In this article it is argued that it is possible to accept the challenges posed by constructivist/post‐modernist thinking without having to give up valuable middle ground.

The Misuse and Use of Science in Family Therapy

The wish to adopt ideas and metaphors from science can have a constricting effect on thinking about family therapy theory and practice. We describe three examples from the recent literature. The two problems describe: (a) borrowing the prestige and certainty of scientific ideas and metaphors and using them as cultural representations of reality, and (b) embracing certain philosophically comprehensive systems of thought. We then recommend some appropriate borrowing from the natural history tradition of science, and give some examples of ways in which that tradition has widened rather than narrowed the range of ideas that are used in family therapy.

Secrets in Families and Family Therapy

The daily practice of marital and family therapy is replete with family secrets, including such intimate and profound areas of family life as birth, adoption, parentage, infertility, physical and mental illness, sexual orientation, incest, rape, abortion, addictions, divorce and suicide. Such secrets confront the therapist with the need to examine one's own values regarding secrecy and openness, and to devise methodologies that are both ethical and effective.

Morality in group and family therapies: multiperson therapies and the 1992 ethics code.

Although virtually every psychotherapeutic approach or orientation has adapted group and family therapy to its conceptions of psychological dysfunctions and how to treat them, levels of training of practitioners in all of these approaches are often insufficient to meet the requirements of ethically as well as technically responsible conduct of treatment for persons in groups and families. The new ethics code (American Psychological Association [APA], 1992) does include a few issues specific to multiperson therapies, but other issues critical to the competent practice of group and family therapy remain unaddressed. The result can be confusing to those applying standards for individual therapy to multiperson therapies. It is argued that the classical ethical concerns of psychotherapists, informed consent, confidentiality, countertransference reactions, aand intrusions of therapist values, require special sensitivity to how they are expressed in mulitperson therapies. Practitioners of group and family therapies must be better sensitized to the technical distinctions and the associated ethical vulnerabilities of the modalities they use. Future planning for revision of the APA ethics code should take these factors into account.

From Irreverence to Irrelevance?: The Growing Disjuncture of Family Therapy Theories from Social Realities

The author believes that family therapy theory and practice has become further and further removed from the changing economic and political realities of professional practice as well as to the worsening everyday social realities of the many millions of potential clients that the field purports to serve. New theoretical developments, while offering new perspectives through which therapists may view their work, remain decidedly apolitical, decontextualizing therapists and therapy from the larger social and cultural milieus. An open examination and thorough discussion of these changing realities is proposed as a partial antidote to the increasing irrelevance of the field.

Considering Culture and Oppression

This article urges the adoption of an ecological view of sexual child abuse, with attention to the individual, the family, the ethnic culture, and wider society. Case material is drawn from work with Puerto Rican families and research with Puerto Ricans in the United States on issues of sexual child abuse. Implications for the practice of family therapy are outlined.

A dialogic perspective for family therapy: the contributions of Martin Buber and Gregory Bateson

This paper concerns the philosophies of Martin Buber and Gregory Bateson, and the application of their philosophies to family therapy. The relevance of Buber's philosophical concepts to a social constructionist perspective in family therapy is given particular attention. Central points of Buber's and Bateson's theoretical perspectives are reviewed and compared. Both thinkers believe that relationship is the primary ingredient in the world of the living, and both have a commitment to the concept that difference is the essential building block of the world of the living. Buber and Bateson, as philosophical anthropologists, are concerned with questions of how their ontologies or epistemologies can be applied to the domain of human interactions, including various healing relationships such as family therapy. This paper shows how their theoretical ideas fit into family therapy thinking and practices, particularly from a social constructionist perspective.

Rhetorical theory and family therapy practice

The study found that a connection exists between rhetoric and therapy because both fields are interested in using language as a tool for generating change. Persuasion is viewed as inherent in human communication, even though people do not necessarily intentionally attempt to persuade others. Following a brief (but detailed) explanation of the theoretical stance which informs the implementation of rhetorical techniques in therapy, three pragmatic exemplars are offered to demonstrate the employment of two classical rhetorical concepts, the parastasis catalogue and syncrisis.

Ecology, Ethics, and Responsibility in Family Therapy

Family therapy has become a popular mode of contemporary mental health care, encouraging more therapists to list marriage and family problems among their advertised specialties. This prominence has increased professional and public awareness of the ethical challenges inherent in the practice of marriage and family therapy. Working with relationships raises complicated issues regarding the role of the therapist vis-a-vis each individual in treatment in light of the focus on a couple or family system. Aspects of therapy as routine as emotional support become more difficult to provide when several clients are in the room. Acting as a gatekeeper for information flow between family members-including dealing with family secrets-can be burdensome. Power inequities between the genders and the generations are highlighted, thereby politicizing some therapeutic decisions. Complex legal and moral issues arise, such as dealing with child sexual abuse. Thus, the concept of therapeutic responsibility broadens and deepens (Green & Hanson, 1989; Hare-Mustin, 1980; Smith, 1991; Wendorf & Wendorf, 1985). The following case illustrates some of these complexities: