bluuebunny/crossref_metadata_2025 huggingface dataset:
Strategic Interventions Within a No‐Treatment Frame
Authors: JONES C. WAYNE
Published: August 2004

It is the thesis of this paper that there are some problem contexts in which the risk for either no‐response or negative effects of therapy are considerably greater than the probability of positive outcomes, despite the competence level of the therapist or special characteristics of the client system. It is these contexts that warrant the inclusion of a no‐treatment option among therapists' current range of treatment choices. Rather than turning client systems away in an absolute sense, however, no‐treatment is presented as a frame in which therapists are not obligated to help change a problem but may continue to have some form of contact with the client‐system. Four no‐treatment prescriptions are presented that can be employed strategically either (a) to increase available opportunities for therapist leverage within a problem context, or (b) to amplify competence in pivotal family members when the problem context demands immediate competent responses. Case studies are presented to highlight the contextual information used in making no‐treatment decisions.
Individual Marital Therapy: A Critical Reappraisal
Authors: WELLS RICHARD A. , GIANNETTI VINCENT J.
Published: August 2004

The belief that individual marital therapy (IMT) is an ineffective form of treatment for marriage problems and markedly inferior to the conjoint approaches has become almost an article of faith in family therapy circles. This position was originally advanced in the influential reviews of the research literature conducted by Gurman and Kniskern, and their conclusions have been cited in numerous other articles. This paper re‐reviews the research studies purportedly supporting this conclusion and finds almost all of them to be invalidated by gross flaws in design and implementation. It is argued that from the highly inadequate evidence available, no conclusions can be reached concerning either the absolute or relative effectiveness of IMT.
Individual Marital Therapy — Have Reports of your Death been Somewhat Exaggerated?
Authors: Gurman Alan S. , Kniskern David P.
Published: August 2004

In this reply to Wells and Giannetti's critique of our earlier reviews of research in family therapy, we demonstrate that the sense of absolute certainty with which they reappraise and dismiss as useless the studies we reviewed on individual marital therapy is unjustified. We also consider the implications of their critique and the conclusions they derive from it for public policy and clinical practice. Though we acknowledge the appropriateness of certain aspects of their critique, we continue to hold to our original position that, for now, there is ample empirical warrant for considering conjoint therapy to be the treatment of choice for marital problems.
REJOINDER: WHITHER MARITAL THERAPY?
Authors: Wells Richard A. , Giannetti Vincent J.
Published: August 2004

It is apparent that Gurman and Kniskern have greatly revised their original position in response to our critique. We believe that their revised position is more fully consonant with the available empirical evidence, although certain areas of disagreement between us are still evident. Overall, we believe that this dialogue has generated some promising lines for future research and clinical practice.
Communication Deviances in Parents of Schizophrenics
Authors: RUND BJØRN RISHOVD
Published: August 2004

In an attempt to make a multimethod assessment of communication deviance in parents of schizophrenics, a communication conflict situation (CCS) and the TAT were used to obtain qualitative and quantitative measures of communication for a sample of 50 parental couples, 21 of which were parents of schizophrenics, 9 were parents of nonpsychotic psychiatric patients, and 20 were parents of normals. The results were a general confirmation of earlier reports that communication deviance is an outstanding characteristic in families with a schizophrenic offspring. The most important finding, however, was that parents of paranoid and nonparanoid schizophrenics score very differently on a majority of the communication variables. Parents of nonparanoid schizophrenics form one extreme on a continuum of communication deviance, and parents of paranoid schizophrenics and normals the other. Egocentrism, measured by CCS, turned out to be the single qualitative variable with best discriminating power across all groups.
Negative Explanation, Restraint, and Double Description: A Template for Family Therapy
Authors: WHITE MICHAEL
Published: August 2004

Gregory Bateson's notions of negative explanation, restraint, and double description are discussed. The difficulties that families often experience in the discovery of new solutions to problems are explained according to the terms of these notions. A map for therapy is derived that emphasizes the therapist's contribution to the therapeutic system's state of “readiness” for the discovery of new solutions. Details of therapist/family participation in the endurance of new discoveries are examined. An approach to the treatment of the context for childhood fears and obsessive/compulsive behavior demonstrates one application of this map.
Why Do We Still Call Them “Paradoxes”
Authors: DELL PAUL F.
Published: August 2004

The fact that therapists label some events “paradoxical” may suggest that our current beliefs or theories are limited in their ability to adequately account for those phenomena. It is argued that our underlying belief in objectivity surrounds therapeutic “paradoxes” with a persistently paradoxical aura, and leads to confusion in our understanding of a variety of phenomena. Maturana's ideas regarding structure determinism, instructive interaction, and phenomenal domains are used to suggest an answer to these difficulties. It is claimed that the problematic status of many theoretical concepts (for example, communication, information, resistance, homeostasis, and pathology) is revealing of something quite important — that the experiential validity of instructive interaction repeatedly leads us into implicitly or explicitly employing instructive interaction in a domain where it can never be valid: the domain of theory and explanation.
Family Structure and Stress
Authors: LEWIS JERRY M.
Published: August 2004

This report presents an evolving theoretical model of the relationship between normative and severe stresses and a family's organizational structure. It is useful for understanding these processes and for planning treatment intervention for families at several levels of function: competent, dominant‐submissive, chronically conflicted, and severely disturbed.
Quanta, Quarks, and Families: Implications of Quantum Physics for Family Research
Authors: DOHERTY WILLIAM J.
Published: August 2004

This paper offers recommendations for family research in light of the scientific paradigm ushered in by quantum physics in the early twentieth century. After summarizing the basic discoveries of quantum physics, the author discusses philosophical implications of these discoveries, and then presents implications for conducting scientific research about families within a post‐Newtonian paradigm that emphasizes relations, process, and dynamic causation. The author argues for using complementary research models, including linear and systemic, because no one theory or methodology can illuminate fully the inscrutable nature of family processes.
My Family Made Me Do It: The Influence of Family Therapists' Families of Origin on Their Occupational Choice
Authors: GOLDKLANK SHELLY
Published: August 2004

This study is an empirical test and exploration of the folklore about family life correlates of family therapists' occupational choice. The folklore is translated into systems concepts, including role complementarity and the mutually determining effect of process and roles. Fifty‐nine family therapists, 49 siblings of the therapists, and 51 undifferentiated, non‐helping professionals were compared on FACES (29), The Complementary Role Questionnaire, and on demographic data. Inconsistencies in the results led to a critique of the clinical faithfulness of current systems measures. Family therapists did not differ on FACES, but did differ in aspects of roles from their siblings and from the control professionals.
Features of Families with Major Affective Disorders
Authors: STIERLIN HELM , WEBER GUNTHARD , SCHMIDT GUNTHER , SIMON FRITZ B.
Published: August 2004

This article reports the authors' observations on 22 families in which a young adult member has been diagnosed as manic‐depressive, and on 11 families in which a member has been diagnosed as suffering from major schizoaffective disorder. All families could be described as extremely rigid and bound‐up systems. Many of them were characterized by a “restrictive parental complementarity” and reciprocal delegation, and they shared certain cognitive features and assumptions. “Manic‐depressive” families showed similarities as well as differences when compared with families in which there were schizophrenic and serious psychosomatic disorders.
Coping in Families with a Retarded Child
Authors: Beavers Jeanette , Hampson Robert B. , Hulgus Yosef F. , Beavers W.Robert
Published: August 2004

The impact of a retarded child on a family has previously been described by individual family members' reports. This study of 40 families, 10 in each of four critical periods during the life of the retarded child, utilized videotaped interviews with whole families, with subsequent clinical observation and analysis based on the Beavers family assessment model. Healthy and problematic adaptations are delineated, with specific attention to systems concepts such as family structure and power, member individuation, feeling expression, and values. The report includes data analysis and a summary of pattern differences in family functioning.
Systemic Practice
Authors: GIACOMO DANIEL , WEISSMARK MONA
Published: August 2004

In this paper we propose to develop a methodology, based on a set of isomorphic patterns of practice, for studying the operational competencies of systemic therapists. By attending to the therapists' actions at the level of practice, we have identified unifying principles that run across the different models of systemic family therapy. This is a pattern of action that we call “systemic practice.” In order to show the application of this methodology in the art of practice, we have analyzed excerpts from two videotaped sessions.
In Defense of “Lineal Causality”
Authors: DELL PAUL F.
Published: August 2004

It has often been said that ideas about lineal and circular causality may be theoretically profound, but that the reputed impossibility of lineal causality seems to fly in the face of our experience and our common sense. The above humorous jibe at theory goes straight to the heart of the matter. Bateson's epistemology of lineal and circular causality does not describe our everyday experience. Batesoh's epistemology explains our experience.
The March of Time: Rigid or Chaotic Transactions, Two Different Ways of Living Time
Authors: AUSLOOS GUY
Published: August 2004

In this paper the author shows that families do not live time in the same way. In families with rigid transactions, time is arrested; in families with chaotic transactions time is eventful. These different ways of living time are true of all systems, and parallels are drawn with political systems. Therapists must thus manage the therapeutic time in different ways, and this depends, among other factors, on their “personal equation.” To achieve this, some guidelines are given, and two techniques that we call photograms and historiograms are described.
“Detoxification” of Vietnam War Trauma: A Combined Family‐Individual Approach
Authors: ROSENHECK ROBERT , THOMSON JANE
Published: August 2004

Treatment with families of veterans suffering from the aftereffects of combat trauma in the Vietnam War often requires a preliminary phase of disjoint treatment, in which family members are seen separately, before conjoint treatment can proceed. In this disjoint phase of treatment, wives and children are introduced to the brutal realities of Vietnam combat experience and to an understanding of its sequelae. This disjoint phase of family therapy detoxifies combat experience so that it can be approached in subsequent conjoint sessions along with more traditional family therapy issues.
Employing the God‐Family Relationship in Therapy with Religious Families
Authors: GRIFFITH JAMES L.
Published: August 2004

In many religious families, God functions as a crucial family member, stabilizing interpersonal relationships and engaging in daily family transactions. In the psychological role of a transitional object, God can be usefully employed by the family therapist in therapeutic interventions, when the therapist keeps the focus upon the interpersonal relationship with God rather than the specific content of religious beliefs. This approach can access a vital resource in the family, particularly when conditions for therapy are otherwise difficult, such as an isolated, enmeshed dyad presenting alone for therapy. Four case examples illustrate how one may use this approach in family therapy.
The Cybernetics of Physical Illness
Authors: DYM BARRY
Published: August 2004

This is a speculative essay on the application of cybernetic concepts to the diagnosis and treatment of physical illness. The essay assumes that there is a unified biopsychosocial field in which the designation of illness as “physical” violates the ecological wholeness of the field. Although the field is complex, clinical intervention requires a degree of simplicity. This simplicity is sought by describing biopsychosocial experience in terms of recursive cycles. Clinical intervention is discussed as a disruption of recursive cycles.
Family Interaction Coding Systems: A Descriptive Review
Authors: GROTEVANT HAROLD D. , CARLSON CINDY I.
Published: August 2004

Summaries and critique of 13 coding systems used in the observation of family interaction are presented. Each system is first described in terms of its theoretical origins and key constructs. Comparative analyses are presented for physical descriptions of the codes, administrative procedures, reliability, validity, and clinical and research utility. Recommendations for further development of family interaction coding systems are presented.
When Is a Parent Out of the Picture? Different Custody, Different Perceptions
Authors: ISAACS MARLA BETH , LEON GEORGE H. , KLINE MARSHA
Published: August 2004

This study investigated how 200 children from mother‐, father‐, or joint‐custody arrangements perceived their divorced families. The authors argue that it is not the type of custody that shapes the child's view of whether one parent is peripheral but, rather, the nature of relationships within the various custody arrangements.
Formulations of Self and Family Systems
Authors: BRIGHTON‐CLEGHORN JANET
Published: August 2004

The observations of systemic family therapy and self psychology fit together conceptually because both rest upon systems theory. Underlying assumptions common to both fields of inquiry are reviewed. The concept of the self and its parts is examined, with discussion of its systems properties featuring stability and change. Parallels are noted between (a) healthy self‐functioning and healthy family functioning; (b) self‐formation processes and family developmental processes; and (c) sense of self and family paradigm. It is suggested that there are isomorphic patterns in these formulations that allow us to switch back and forth easily between the individual and the family. Two clinical case examples are also included.
Chronic Illness and the Life Cycle:A Conceptual Framework
Authors: ROLLAND JOHN S.
Published: August 2004

This article provides a conceptual framework for thinking about the system created at the interface of chronic illness with the family life cycle. First, a psychosocial typology and time phases of illness schema is described as a necessary, preliminary step to create a common language that bridges the worlds of illness, individual, and family development. This schema organizes similarities and differences between diseases in a manner useful to psychosocial‐developmental rather than biomedical inquiry. Then, drawing on several major life‐cycle theories in the literature, key concepts (periods of transition, life‐structure building and maintaining, centripetality, and centrifugality) are used in a complementary fashion to link these three lines of development. Equipped with these psychosocial languages, consideration is given to transgenerational aspects of illness, loss, and crisis, and the interwoven threads of illness, family, and individual development. Clinical vignettes are provided to highlight this conceptual framework.
Treatment of Families During Life Transitions: Matching Treatment to Family Response
Authors: WORTHINGTON EVERETT L.
Published: August 2004

This article examines the conceptualization and treatment of families during normative and non‐normative life transitions. Variables identified by individual and family developmental theorists account for some variation in responses of families to life transitions. Three family variables are identified as critical to practitioners' understanding of families: disruption of time schedules, number of new decisions involving initial disagreement, and pretransition family conflict. Different responses are hypothesized for families high or low on each variable. Six treatments of families are identified: historical family therapy, structure/process family therapy, experiential family therapy, psychoeducational approaches, family crisis intervention, and enrichment. The likelihood of success of each treatment is predicted on the basis of a family's response to the transition.
On Description of Family Therapy
Authors: GOLANN STUART
Published: August 2004

This article offers a critical analysis of the convergence of two perspectives, constructivism and the cybernetics of cybernetics, as they affect the value placed upon description of family therapy. An analogy to the problem of describing interaction in family therapy is drawn from the history of the representation of reality in art. It is argued that (a) the “interactional approach” is incompatible with radical constructivism, and (b) “the shift from observed to observing systems” has resulted in an unnecessary devaluation of representational description of family interaction.
Infertility as Boundary Ambiguity: One Theoretical Perspective
Authors: BURNS LINDA HAMMER
Published: August 2004

Infertility as a life event can be understood from a number of conceptual perspectives: a developmental crisis, a grief reaction, a disruption of marital contracts and roles, a crisis of identity, sexuality, and/or values, or a challenge of decision‐making processes. Stress theory and the construct of boundary ambiguity can augment the understanding of the crisis of infertility by providing a different approach and unique perspective. It is the hypothesis of this article that the involuntarily childless couple may experience infertility as a stress of boundary ambiguity, that is, not knowing who is in and who is out of the family system. As infertile couples attempt to make the transition to parenthood they may experience the child they wish to have as a family member who is psychologically present but physically absent.
Family Characteristics and Posttraumatic Stress Disorder: A Follow‐Up of Israeli Combat Stress Reaction Casualties
Authors: SOLOMON ZAHAVA , MIKULINCER MARIO , FREID BATIA , WOSNER YOHANAN
Published: August 2004

This study assessed the role of family status and family relationships in the course of combat‐related posttraumatic stress disorder (PTSD). The sample consisted of 382 Israeli soldiers who suffered a combat stress reaction episode during the 1982 Lebanon War. Results showed that one year after the war married soldiers had higher rates of PTSD than did unmarried soldiers. Furthermore, higher rates of PTSD were associated with low expressiveness, low cohesiveness, and high conflict in the casualties' families. Theoretical, methodological, and clinical implications are discussed.
Family Reconciliation as a Response to Adolescent Crises
Authors: GUTSTEIN STEVEN
Published: August 2004

Concern for adolescents who act in dangerous, life‐threatening ways has heightened dramatically in recent years. Many of these adolescents appear to come from nuclear families isolated from their kinship systems. Without the mediating effects of kin, the adolescent transition can become a major crisis. Kinship systems remain cohesive when members can reconcile their beliefs about essential aspects of family functioning with the demands for adaptation during major life transitions. Reconciliation is lost when members believe that kin can no longer be trusted to insure their well‐being. Kinship fragmentation ensues as family members leave the field or are excluded. Isolated nuclear families then rapidly lose the resilience to respond to life transitions without resorting to extreme, maladaptive solutions. The Systemic Crisis Intervention Program (SCIP) uses the opportunity of the crisis precipitated by the adolescent's life‐threatening behavior to alter family myths that have led to network fragmentation. Crisis teams mobilize and meet with kin in four‐hour gatherings to foster reconciliation and kinship system reintegration.
On Second‐Order Family Therapy
Authors: GOLANN STUART
Published: August 2004

If family therapists remain aware of the indivisible and recursive nature of their interactions with families, and if they use this awareness to form a collaborative rather than a hierarchical therapeutic system, and at the same time minimize their attempts to change persons or family structures in strategic or predetermined ways, then they may be said to be practicing a “second‐order” family therapy. This article analyzes the development of the second‐order position on therapist power and influence, concluding that it is inconsistent and possibly disingenuous.
Theories of Family Adaptability: Toward a Synthesis of Olson's Circumplex and the Beavers Systems Models
Authors: LEE CAMERON
Published: August 2004

Two typologies of family process, Olson's Circumplex Model and the Beavers Systems Model, are discussed, focusing particularly upon their definitions of family adaptability. It is argued that the two typologies are not simply “separate but equal” (11), but, rather, that there is an ambiguity in the Circumplex Model that disguises a fundamental theoretical overlap between the two. Olson's definition of adaptability is founded upon the concepts of morphogenesis and change; Beavers builds upon the concepts of negentropy and competence. It may be shown, however, that both understandings are necessitated by the theoretical writings of Olson and his colleagues. The nature of this ambiguity in the Circumplex Model is critically explored, and a higher‐order model that attempts to synthesize these two theories is proposed.
A Theoretical Framework for Evaluation and Treatment of the Victims of Child Sexual Assault by a Nonfamily Member
Authors: VAN SCOYK SUSAN , GRAY JANE , JONES DAVID P.H.
Published: August 2004

Thirty‐seven families whose children were victims of sexual abuse by a non‐family member were evaluated and treated during a nine‐month period. The average age of the children was 5.36 years. The youngest children were boys, and all the adolescents were girls. A theoretical framework adapted from Ferreira's and Byng‐Hall's work was developed to assess and treat child victims of sexual molestation and their families. The format consists of three concepts. First, the trauma from sexual abuse, being outside the realm of usual human experience, creates a breach in the family's adaptive and protective shield, including its shared values and beliefs. Second, the trauma has a “derailing” effect on the child's and family's predicted passage through their world. And third, issues that arise as a consequence of disclosure are intimately tied to preexisting family myths and beliefs. Evaluation, treatment, and short‐term outcomes are discussed.
The Anorectic Process in the Family: A Six‐Stage Model as a Guide for Individual Therapy
Authors: SELVINI‐PALAZZOLI MARA , VIARO MAURIZIO
Published: August 2004

This article presents a conceptual framework for individual treatment with chronic anorectic patients. In the first part of the article, the six‐stage model for the anorectic process developed over the past years by M. Selvini‐Palazzoli and her team is briefly explained. After presenting the model, we then discuss some related concepts, namely, “family game,”“rule,” and “strategy.” Finally, the therapeutic technique in individual treatment is discussed. Two basic assumptions underlie this technique: first, the therapeutic relationship is instrumental, its main purpose being to improve the patient's personal relations outside therapy; second, the focus of the treatment is on the strategic incapacity of the patient who is caught up in and unable to cope with the “concealed family game.”
The Transition to Parenthood: I. The Rating of Prenatal Marital Competence
Authors: Lewis Jerry M.
Published: August 2004

This article is the first of three that will present data from the Timberlawn Psychiatric Research Foundation Young Family Project, a study of the development over time of competent family systems. The Project is briefly described and findings are presented from the initial data collection period. The operational definitions of marital competence and the Continuum of Marital Competence are presented, and the data are interpreted to suggest that the spouses' levels of individual psychological health, their agreement on values, and their socioeconomic status are related to the level of marital competence. The level of prenatal marital competence at Time 1 is used as an independent variable with which to predict both changes in marital structure and incorporation of the child into the family system at 3 months and 1 year postpartum. The results of these analyses will be presented in two subsequent articles.
Scripts and Legends in Families and Family Therapy
Authors: BYNG‐HALL JOHN
Published: August 2004

Protective family scripts prescribe interaction that the family believes is needed to avoid potentially dangerous scenarios. Certain family legends provide moral tales that illustrate these dangers and hence reinforce these scripts. Together they contribute to family mythology. In the absence of adequate research data about specific effects of particular interventions, the therapist has to rely on his or her own beliefs about what works to change unhelpful family beliefs and interaction patterns. This essay examines the interplay between the two belief systems by exploring one of the author's own family legends and then seeing how its injunctions have been played out in his family therapy practice, thereby illustrating how myths and protective practices may be set up within the field of family therapy and its training.
Mis‐taken Love: Conversations on the Problem of Incest in an Irish Context.
Authors: MCCARTHY IMELDA COLGAN , BYRNE NOLLAIG O'REILLY
Published: August 2004

An emotive consciousness of the issues surrounding incest frequently calls forth revulsion, outrage, fear, concern, and competition. Such responses often legitimate a range of actions that include the protection of children, the blaming of mothers, and the punishment of fathers. This article explores a “systemic” disposition1 in conversations on father‐daughter incest. The notion of a “Fifth Province” (from Celtic mythology) is invoked wherein all emotions, judgments, and descriptions can find acceptance, and whereby a language of control and competition, implicitly negating individuals and their relationships, is suspended as a rationale for action.
Systemic Crisis Intervention as a Response to Adolescent Crises: An Outcome Study
Authors: GUTSTEIN STEVEN E. , RUDD M. DAVID , GRAHAM J. CHRISTOPHER , RAYHA LINDA L.
Published: August 2004

The present study demonstrates the safety and effectiveness of an outpatient program designed to respond to adolescent‐precipitated crises by mobilizing and restructuring the family's kinship system. Families of 75 adolescents at risk for hospitalization were followed up to 24 months after treatment with Systemic Crisis Intervention. Measures of offspring and family functioning, suicidal behavior, institutional use, and treatment costs are presented. Results clearly demonstrate the safety, effectiveness, and economic viability of Systemic Crisis Intervention.
Family System Functioning: Behavior in the Laboratory and the Family Treatment Setting
Authors: DOANE JERI A. , HILL LEONARD W. , KASLOW NADINE , QUINLAN DONALD
Published: August 2004

The Family System Functioning (FSF) scale is a new instrument for measuring dimensions of the intrafamilial environment thought to be important in recovery from major psychiatric illness. Modest statistical correlations were obtained when FSF ratings of laboratory‐based family interactions were compared with researcher‐guided therapist ratings of FSF based upon the family's behavior in family therapy sessions during the subsequent month. The data from these two settings provide support for the validity of some of the scales. Because of the modest size of the correlations, however, behavior in the laboratory setting may not always be an accurate indicator of how the family will behave in the early weeks of family therapy.
Open and Closed Adoption: A Developmental Conceptualization
Authors: DEMICK JACK , WARNER SEYMOUR
Published: August 2004

Given the annual increase in the multiple forms of adoptive practices within contemporary American society, research aimed at assessing the effects on the adoptees, their families, and the community of “open” versus “closed” adoption (communication versus no communication between biologic and adoptive parents) of healthy infants is sorely needed. Before this can be done, researchers and mental health professionals need to make sense of the myriad of findings in the adoption literature. With the goal of stimulating such research, the present article is comprised of: (a) a review of the contemporary, social scientific literature on adoption, which has focused for the most part on traditional, closed adoption; and (b) a description of a program of research on adoption that is generated from a theoretical orientation, which has already proven valuable in the examination of other developmental life transitions. Based on a holistic, developmental, systems orientation to person‐in‐environment functioning, this approach provides a developmental conceptualization of both open and closed adoption. Hopefully, the literature review and the research program described here will stimulate other investigators to conduct research on this important problem from their own perspective or from variations of research described in this article.
The Visitation Schedule and Child Adjustment: A Three‐Year Study
Authors: ISAACS MARLA BETH
Published: August 2004

Frequency and regularity of visitation is studied over time for a sample of recently separated mother‐custody families. Results suggest that stability of visitation is more predictive of child adjustment than frequency of visits and that these effects are manifested over time. Setting up and maintaining a visitation schedule are shown to be related to the relationship that parents establish with each other in the first year of the separation.
The Transition to Parenthood: II. Stability and Change in Marital Structure
Authors: Lewis Jerry M.
Published: August 2004

At 1 year postpartum, 22 of 38 couples demonstrated the same level of marital competence as they had prenatally, 14 couples demonstrated deterioration in their marital relationship, and 2 couples were improved. At each of four levels of marital competence, there was a trend for the couples to demonstrate the same relationship response to parenthood. Highly competent relationships remained at high levels of competence. Competent but pained relationships were most vulnerable to regressive change in structure. Dominant‐submissive, complementary relationships tended to remain stable at that level. Dominant‐submissive, conflicted or severely conflicted relationships were most unpredictable and stability, regression, and improvement were seen. These findings are explored for possible correlations and are discussed from the perspective of several current models of family development.
The Time‐Line Genogram: Highlighting Temporal Aspects of Family Relationships
Authors: FRIEDMAN HERBERT , ROHRBAUGH MICHAEL , KRAKAUER SARAH
Published: August 2004

The genogram, or family diagram, is an assessment tool widely used by clinicians to study family members and their relationships over several generations. The standard genogram format is limited, however, because it does not show temporal patterns directly. An alternative, the Time‐Line Genogram (TLG), which plots time on the vertical axis to display life events and changes in relationships when they actually occurred, highlights temporal aspects of family history that the standard format sometimes obscures.
Functional Illness and Family Functioning: A Comparison of Healthy and Somaticizing Adolescents
Authors: WALKER LYNN S. , McLAUGHLIN F. JOSEPH , GREENE JOHN W.
Published: August 2004

This study examined the usefulness of the Circumplex Model of Marital and Family Functioning for discriminating between families of healthy adolescents and families of adolescents with functional somatic complaints. The findings did not support the expected curvilinear relationship between symptomatology and the FACES II family dimensions of cohesion and adaptability. Questions are raised regarding the degree of correspondence between the constructs of enmeshment and rigidity as assessed clinically and as measured by the Circumplex Model.
Family Therapy in Trouble: Psychoeducation as Solution and as Problem
Authors: HUNTER DAVID E. K. , HOFFNUNG ROBERT J. , FERHOLT JULIAN B.
Published: August 2004

The authors cite clinical literature attesting to the importance of recognizing the family, rather than the individual, as the proper locus of conceptualizing, diagnosing, and treating mental illnesses. Specifically with regard to severe psychiatric illnesses, in particular schizophrenia, family dysfunction contributes to the emergence of the illness, significantly affects its course, and strongly influences the achievement and maintenance of treatment gains. Currently, a movement is afoot to limit sharply the amount and kind of treatment offered to schizophrenic patients and their families. Rooted in a “medical model” or “biogenic” view of the etiology of schizophrenia, this school of thought prescribes psychoeducation as the family treatment of choice. The present article looks at some misconceptions regarding treatment that prompted a widespread turning away from psychoanalytically oriented family psychotherapy for schizophrenic patients and their families, examines the reductionism (biological and behavioral) inhering in the exclusive use of psychoeducation, and looks at the clinical dangers of such reductionism. Finally, it proposes that family psycho‐therapists should not abandon a concern with the inner lives of severely ill patients and their families in the face of spuriously generalized claims made by reductionist researchers.
A Record‐Keeping Format for Training Systemic Therapists
Authors: BERNSTEIN ROBERT M. , BURGE SANDRA K.
Published: August 2004

Training in systemic therapy necessitates a structured approach to teaching systemic thinking. The Systemic Therapy Sessions Summary Form, a record‐keeping method, is presented as a tool for enhancing training in systemic therapy. The purpose of this form is to provide the structure for the trainee to develop circular hypotheses, to connect reflexively the assessment and intervention components of therapy, and to maintain a sense of the evolving nature of therapy across sessions. A case example illustrates the use of this record‐keeping format.
Human Systems as Linguistic Systems: Preliminary and Evolving Ideas about the Implications for Clinical Theory
Authors: ANDERSON HARLENE , GOOLISHIAN HAROLD A.
Published: August 2004

From our earliest practice of family therapy at medical schools, private family therapy institutes, and public agencies, our work with difficult populations that do not respond to current treatment technologies has reminded us of the inadequacies of our theoretical descriptions and the limitations of our expertise. This work has influenced our current, evolving clinical theory as we move from thinking of human systems as social systems defined by social organization (role and structure) to thinking of them as distinguished on the basis of linguistic and communicative markers. Hence, for us, the social unit we work with in therapy is a linguistic system distinguished by those who are “in language” about a problem, rather than by arbitrary andpredetermined concepts of social organization. We call the therapy system a problem‐organizing, problem‐dis‐solving system.
The Family Systems of Munchausen Syndrome by Proxy
Authors: GRIFFITH JAMES L.
Published: August 2004

Munchausen Syndrome by Proxy describes a parent who fabricates the appearance of physical illness in a child. Previous descriptions of the syndrome have focused exclusively upon medical or psychiatric assessments of the involved child and perpetrating parent. The family evaluations of two cases presented here suggest that Munchausen Syndrome by Proxy may be a systemic syndrome generated when a mother already possessing a somatoform or factitious disorder joins an enmeshed, authoritarian family system possessing a systemic history of exploitation of children. We suggest that measures instituted to protect the abused child must take into account the systemic function of the Munchausen by Proxy behavior in maintaining family stability, lest such measures be rendered ineffective by family members. When there is ongoing victimization of perpetrating parents in a similar pattern of dominance/submission within their own family of origin, disruption of these intergenerational patterns of exploitation may be a necessary component of treatment.
Emotionally Disturbed, Adopted Adolescents: Early Patterns of Family Adaptation
Authors: GROTEVANT HAROLD D. , McROY RUTH G. , JENKINS VIVIAN Y.
Published: August 2004

This article focuses on the development of compatibility or goodness‐of‐fit within adoptive families and on the possible contribution of such problems to emotional disturbance of adolescents. Subjects included 50 adopted adolescents in residential treatment (mean age = 14.96) and their families, and 50 nonadopted adolescents in treatment (mean age = 14.90) and their families. The child, both parents, and the child's caseworker were interviewed. Three distinctive interactional patterns presenting adaptational challenges are discussed: the family's adaptation to the child's hyperactivity, the family's adaptation to the child's avoidance of contact and cuddling from early infancy, and perceived incompatibility between the child's personality and the parents' style. Results are discussed in terms of behavioral and attributional contributions of both the child and parents to the development of compatibility. Implications for clinicians are discussed.
Comparing Lesbian and Heterosexual Couples on the Circumplex Model: An Initial Investigation
Authors: ZACKS ELLIE , GREEN ROBERT‐JAY , MARROW JOANNE
Published: August 2004

This study extends the research on the Circumplex Model to a population of lesbian couples. Instruments consisted of a demographic questionnaire, FACES III, and the Family Satisfaction Scale. Lesbian couples reported significantly higher levels of cohesion, adaptability, and satisfaction than did heterosexual couples. Exceptionally high levels of cohesion and adaptability may help lesbian couples function more successfully in a predominantly heterosexual world. Further, women's socialization may predispose female couples to form more cohesive and adaptable relationships than heterosexual couples. This article also emphasizes the cultural relativity of family norms for studies of lesbian and all minority population couples.
Testing Clinical Hypotheses by Means of “Falsificationist Epistemology”
Authors: RAFFIN CINZIA
Published: August 2004

A family therapist using the “falsificationist epistemology”1 can, during the first session, test the hypotheses formulated on the telephone intake chart and also gather further information to reexamine and redefine these hypotheses. We shall examine a case treated by Dr. G. Prata, analyzing the most important phases of the first session, and stressing what methodological and tactical choices were designed to test the leading hypothesis of the “game” played by this family.
Reflections on the Circulation of Concepts between a Biology of Cognition and Systemic Family Therapy
Authors: VARELA FRANCISCO J.
Published: August 2004

This article is a critical examination of the possible relevance of a specific approach to cognitive science for systemic family therapy. I provide a way of comparing the conceptual backgrounds for both these fields and, on that basis, propose some conclusions that underline the difficulty of the task.
Some Aspects of Loneliness in Families
Authors: LARGE TOM
Published: August 2004

Although awareness of the harmful effects of loneliness has increased in recent years, lonely persons continue to be viewed as family outsiders or nonfamily. Beginning with the general‐systems concept of loneliness as having a healthy, adaptive function in families, this article explores the family context of different degrees of loneliness. It assumes that prolonged loneliness (in addition to its meaning for the individual system) is a manifestation of certain kinds of family processes. Five such processes involved in the prolonging of loneliness are suggested: unresolved grief, pathological certainty, synchronicity, family expansion, and parental abdication.
Outcomes of Systemic/Strategic Team Consultation: I. Overview and One‐Month Results
Authors: GREEN ROBERT‐JAY , HERGET MARY
Published: August 2004

This is the first in a series of reports on an experimental, small‐sample study of systemic/strategic team consultations. This report describes a “Milan‐informed” method of team consultation for resolving therapy impasses. It then focuses on the initial one‐month outcomes from the larger 3‐year project. Eleven therapists were asked to select two ongoing cases matched for difficulty. While all cases continued in regular therapy, one of each therapist's cases was also selected at random to participate in a systemic/strategic, five‐part team consultation. Analyses of one‐month follow‐up data showed that clients who participated in the team consultation were more likely to achieve their main and overall treatment goals than clients who received only regular therapy (p's < .05, eta2as a measure of effect size ranging from 32% to 41%). The strong findings of this initial study encourage more widespread use of team consultations as a context for treatment, training, and research.
Social System Responses to Huntington Disease
Authors: KESSLER SEYMOUR , BLOCH MAURICE
Published: August 2004

Huntington disease (HD) is an adult‐onset, genetic disorder with major psychosocial implications. Although many of the psychiatric symptoms of the disorder have been attributed to the HD gene, systems factors may also account for the disorder's manifestations. Three illustrative issues — patient preselection, the denial of symptom onset, and suicide induction — are discussed from the vantage point of family systems thinking. Recently developed capacity for presymptomatic testing of HD despite the current absence of treatment or cure makes it likely that family therapists increasingly will be involved in clinical work with individuals and families in which HD occurs.
Mind‐Body Patterns of Symptom Generation
Authors: GRIFFITH JAMES L. , GRIFFITH MELISSA ELLIOTT , SLOVIK LOIS S.
Published: August 2004

Effective ways for joining family therapy with other treatment modalities are becoming increasingly important as the efficacy of family therapy gains acceptance in the medical and mental health community. When one interfaces family therapy with medical and psychopharmacological treatments, which find the sources of symptoms within individuals, rather than interpersonal systems, careful attention must be paid to the mind and body relationships that guide interactions between family behavior and the somatic physiology of each family member. We present six mind‐body patterns of symptom generation found to be particularly useful for designing multimodality treatments and for communicating the treatment rationale to medical and psychiatric clinicians or to family members. Case examples illustrate their clinical use.
Interactional Treatment of Intractable Hiccups
Authors: BOBELE MONTE
Published: August 2004

This article provides a comprehensive review of the literature regarding nonmedical approaches to the understanding and treatment of intractable hiccups. The author provides a rationale for an interactional view and presents a case in which post‐surgical hiccups were successfully treated, using principles developed by the Mental Research Institute. Of particular interest is the manner in which the therapist managed a system that included the victim's wife, a physician, and other medical personnel who were all trying to eliminate the hiccups. Interventions were designed primarily to alter meanings attributed to the hiccups and, thus, to intervene in the system that was maintaining the problem. This article is presented as a response to Weakland's call for research and practice in family somatics.
The 20 Questions Task with Families of Schizophrenics: Divergent Findings
Authors: CARTER LINDA , LADD JON , ROBERTSON SUSAN R. , ALPERT MURRAY
Published: August 2004

The study attempted to replicate and extend the results of an earlier study by Wild and Shapiro (16), establishing the utility of Mosher and Hornsby's (8) 20 Questions Task as a means of differentiating families with schizophrenic patients from those of psychiatrically hospitalized but nonschizophrenic individuals. In the current study, Wild and Shapiro's original design was expanded and revised by (a) diagnosing patients using Research Diagnostic Criteria rather than hospital diagnoses and (b) including families with schizophrenic daughters and/or one‐parent families, in addition to intact families with schizophrenic sons. Families were comparable on age, intelligence, and socioeconomic variables. The results failed to replicate those reported by Wild and Shapiro, and indicated that the 20 Questions Task was sensitive to differences in family constellation and offspring gender as well as offspring diagnosis. The findings suggest that forms of familial communication deviance detected with the 20 Questions Task may not be unique to families of schizophrenics, thus highlighting the need to expand research on family communication deviance in families with schizophrenic offspring to families with varied family constellations and characteristics.
Family Functioning of Male Alcoholics and Their Female Partners during Periods of Drinking and Abstinence
Authors: LIEPMAN MICHAEL R. , NIRENBERG TED D. , DOOLITTLE RICHARD H. , BEGIN ANN M. , BROFFMAN THOMAS E. , BABICH MARK E.
Published: August 2004

Family functioning of 20 alcoholic male veterans and their female partners was assessed in relation to drinking (wet) and abstinent (dry) intervals. Repeated measures analyses performed on the McMaster Family Assessment Device (FAD) indicated that on all 7 scales of the FAD, alcoholics and their mates perceived family functioning to be better during dry than wet periods. In contrast to their alcoholic mates, female partners gave healthier ratings to all FAD scales except Roles in the dry condition and Affective Involvement in the wet condition. According to published cutoff scores for healthy and unhealthy family functioning, alcoholics as a group viewed their wet and dry family functioning as unhealthy, although the female group regarded the family's dry Problem Solving and Behavioral Control as healthy. These findings suggest that the family functioning of alcohol‐involved couples is biphasic, oscillating between drinking and abstinent periods.