bluuebunny/crossref_metadata_2025 huggingface dataset:
The Epigenesis Of Relational Systems: A Model For Understanding Family Development
Authors: WYNNE LYMAN C.
Published: August 2004

In the “epigenesis” of enduring relational systems, a sequence of four major processes or patterns can be identified: attachment/caregiving, communicating, joint problem‐solving, and mutuality. Although these processes overlap, they optimally follow one another in becoming focally significant and ascendant. In this schema, intimacy makes a complex, deeply valued, but inconstant contribution. The development of family relatedness can be regarded as the prototype for epigenesis of relatively enduring relational systems. In family assessment, the hypothesized sequence qualitatively differs from, yet complements, traditional descriptions of structural transitions in family composition over the family life cycle. Such structural changes occur more or less inexorably whether or not the quality of family relating has progressed. Attempts to bypass stages in the development of salient relational processes are apt to generate impasses and dysfunctions or constrict subsequent growth. This developmental framework may be useful in relational “diagnosis” and in selecting those issues that deserve priority in therapy and research.
Structural Family Therapy
Authors: Jung Marshall
Published: August 2004

Research studies show that Chinese communities in the United States are in need of mental health services. Structural family therapy offers an effective model for treating families in need of therapy. This article describes why and how the model can be applied.
Commentary: A Family is a Family is a Family
Authors: Miller Daniel R.
Published: August 2004

Models are methods of interpreting data. They vary in their suitability to the topic being studied. Models of the family can be divided into those that address questions about the emergent characteristics of the group and those that address questions about the attributes and interactions of individual members. In this paper, these assumptions provide a framework for judging Bogdan's criticism of homeostatic theory and his contention that an adequate description of family process must begin with individuals and their cognitive states.
A Consultation Method Addressing the Therapist‐Family System
Authors: VAN TROMMEL MAX J.
Published: August 2004

This article discusses a method of unlocking a therapeutic system from recursive, cyclical, “more of the same” struggles. Special attention is paid to the therapist‐client system relationship as the unit of observation.
The Resurrection of a Magical Reality: Treatment of Functional Migraine in a Child
Authors: O'CONNOR JOHN J.
Published: August 2004

A magical world view and logic were used in the treatment of a 10‐year‐old girl who was referred because of suicidal threats due to migrainous pain. The treatment consisted of a one‐session intervention with three‐week, six‐month, and one‐year follow‐up indicating elimination of migraine. Within a strategic family therapy, a magical ritual was prescribed that derived from the preoperational logic explicated by Piaget and from the healing practices described in anthropological studies. Such a ritual casts the symptom in a different context, alters the meaning of migraine to the family system, and leads to different interactional patterns. Piaget's theory and anthropological data are discussed as sources of a magical world view to help families and children disengage from a symptomatic system of interactions.
Integrative Shifts for the Theory and Practice of Family Systems Therapy
Authors: KANTOR DAVID , NEAL JOHN H.
Published: August 2004

This paper describes several disagreements among approaches to family therapy and proposes two conceptual shifts providing a more integrative perspective. The first shift focuses on the implications of different ways therapists orient themselves to the developing structures of the therapy system and to the disabled structures of the client system. The second shift reconsiders theoretical approaches in terms of the types of distance they require of the therapist and the types of information these distances provide and ignore. Finally, the paper also discusses a means for classifying the different types of goals therapists establish for their clients, emphasizing that these goals must be consistent with the clients' views of themselves and the world.
Feminism and Family Therapy
Authors: GOLDNER VIRGINIA
Published: August 2004

Feminism has had a profound effect on contemporary culture and on thinking in most academic fields, including psychoanalysis. Interestingly, until very recently it had made virtually no impact on the theory and practice of family therapy. This paper proposes an explanation for this peculiar phenomenon and argues that family therapy has been considerably handicapped by its insularity from the feminist critique.

Utilizing feminist scholarship in psychoanalysis, history, and sociology, the paper analyzes the structural contradictions in family life that family therapists have essentially ignored and then outlines their clinical implications. Key points in the discussion include the argument that systems theory is an inadequate explanatory matrix from which to build a theory of the family, that the archetypal “family case” of the overinvolved mother and peripheral father is best understood, not as a clinical problem, but as the product of a historical process two hundred years in the making, and that power relations between men and women in families function in terms of paradoxical, incongruous hierarchies that reflect the complex interpenetration between the structure of family relations and the world of work. This conceptual model then provides the basis for an analysis and critique of sexual politics as they emerge in the prototypical clinical situation.
Men and the Family
Authors: WEISS ROBERT S.
Published: August 2004

Based on interviews with a sample of occupationally successful men, a description is offered of the competing engagements of work and the family and of the contributions these men see their families making to their functioning. Attention is given to reasons for limited discussion of work events with wives and for the control of emotion and its expression.
Early Interactional Change and Its Relationship to Family Therapy Outcome
Authors: SEEMAN LARRY , TITTLER BENNETT I. , FRIEDMAN STEVEN
Published: August 2004

In the present study, a tailoring methodology was employed to investigate the detection of early interactional change in the course of family therapy and the possible prognostic value of such change for therapy outcome. The predicted relationship received partial support and suggested a model of change in families, with early interactional change as a mediating factor.
Adaptation in Family Systems: A Developmental Perspective
Authors: MELITO RICHARD
Published: August 2004

Adaptation involves a dialectic between permanence and change. At lower levels of organization, mechanisms of permanence and change are split and in opposition; at a higher level of organization, they are integrated so that change can occur while identity is preserved. Current family theory does not account for the ability of families to change while simultaneously maintaining continuity; rather, mechanisms of permanence (morphostasis) and change (morphogenesis) are treated as operating singly or sequentially. Current theory, therefore, accounts only for a lower level of adaptive functioning. Piaget's notion of “regulations” is used to supplement the description of this lower level of adapting. In addition, Piaget's notion of “operations” is used to describe a higher level of adaptive process in which permanence and change are integrated. Because adaptive functioning is tied to degree of organization, one must increase the degree of organization of a family to raise its adaptive level.
The Social Construction of Unreality: A Case Study of a Family's Attribution of Competence to a Severely Retarded Child
Authors: POLLNER MELVIN , McDONALD‐WIKLER LYNN
Published: August 2004

Some families develop unusual or extreme versions of reality and sustain them in the face of a torrent of ostensibly discrediting and disconfirming information. Although the psychological dynamics and functions of such shared constructions have been amply considered, little is known about the routine transactions through which these unusual versions of reality are created and maintained. This paper examines the “reality work” of a family that attributed high levels of performance and competence to the severely retarded youngest child. Observation of videotaped interaction between family members and the child revealed practices that presupposed, “documented,” and sustained the family's version of the child's competence. The practices are similar to those characteristic of interaction between adults and preverbal children. The implications of this similarity for the analysis of cases of folie à famille are discussed.
The Negotiation of Values in Therapy
Authors: APONTE HARRY J.
Published: August 2004

In the study of the therapeutic process, much attention has been given to the inevitable emotional connections between therapist and patient. Little thought has been given, however, to the force of the interaction between the values of the therapist and the family around the issues they are addressing. This paper focuses on the influence of values in therapy and on how the therapist can consciously work with the interaction of his values with those of the family for the benefit of the family he is treating.
A Beginner's Guide to the Problem‐Oriented First Family Interview
Authors: WEBER TIMOTHY , McKEEVER JAMES E. , McDANIEL SUSAN H.
Published: August 2004

The large volume and diversity of family therapy resources can often confuse trainees who are in need of more abbreviated guidelines for managing their clinical responsibilities. This paper presents a structured outline of a problem‐oriented first family interview for the family therapy supervisor and the beginning family therapist. We view the first interview as an integrated process including the important tasks preceding and following the initial family meeting. After the goals that shape the work of the first interview are described, a step‐by‐step guide to the twelve phases of the interview is presented: (1) telephoning; (2) forming hypotheses; (3) the greeting; (4) the social phase; (5) identifying the problem; (6) observing family patterns; (7) defining goals; (8) contracting; (9) checklist; (10) revising hypotheses; (11) contacting the referral person; and (12) gathering records. This approach to the first interview integrates a variety of structural and strategic procedures. The guide, intended for use in conjunction with close supervision, may serve as a foundation on which beginning therapists can build their unique styles.
Stability/Instability in the Alcoholic Marriage: The Interrelationships Between Course of Alcoholism, Family Process, and Marital Outcome
Authors: STEINGLASS PETER , TISLENKO LYDIA , REISS DAVID
Published: August 2004

Thirty‐one alcoholic families who were originally studied in home, multiple‐family group, and laboratory settings were reassessed two years later to determine course of alcoholism and degree of marital stability.

This paper presents data comparing baseline alcohol consumption and family interactional behavior at home with subsequent alcoholism and marital stability outcomes. Findings suggest that the relative degree of stability/instability in these marriages is best understood as a function of the “goodness‐of‐fit” between the relative predictability of drinking on the part of the identified alcoholic and the family's characteristic pattern of interactional behavior at home.
Sibling Deidentification in the Clinic: Devil vs. Angel
Authors: SCHACHTER FRANCES FUCHS
Published: August 2004

A four‐member family structure consisting of two siblings contrasting in personality (sibling deidentification) and each identified with a different parent (split‐parent identification) was recently reported (15). In well‐functioning families, this tetrad or quadrangle is widespread in the first pair of siblings in the family and tends to be more common in same‐sex pairs, suggesting that sibling deidentification is designed to mitigate the relatively intense sibling rivalry characteristic of these pairs and hence to maintain family harmony.

In this collated case report, deidentification is found to follow the same pattern in 39 clinic first pairs. However, contrasting attributes are varied and nonevaluative in nonclinic pairs but mainly “good‐bad” in clinic pairs, with polarization extreme. Results suggest that nonclinic siblings negotiate their identity (being) much as they negotiate about possessions (having) and that negotiations are blocked in clinic pairs, freezing mythic devil or angel identity. Intervention is directed at dislodging this block.
Engaging the Severely Dysfunctional Family in Treatment: Basic Considerations
Authors: WEITZMAN JACK
Published: August 2004

The severely dysfunctional family is a clinical phenomenon that includes families with a wide range of serious symptoms. These families have been characteristically difficult to engage in treatment, and many do not respond well to traditional family therapy techniques. Some of these families do respond to innovative approaches such as paradox. However, many agencies do not have the capability to implement such highly specialized procedures, nor do all severely dysfunctional families respond well to these techniques. Thus, this paper presents a generic approach to the severely dysfunctional family; the emphasis is on facilitating engagement and maintaining sensitivity to the family's need for stability.
The Confusion About Epistemology and “Epistemology”—and What to Do About It
Authors: HELD BARBARA S. , POLS EDWARD
Published: August 2004

The epistemology debates within the field of family therapy have become relatively infrequent in the last year or so, perhaps as a consequence of the confusion they have generated for many family therapists. This article maintains that the primary reason for the confusion is a failure to distinguish clearly between the conventional meaning of the term epistemology, which concerns the nature of knowledge, and the unconventional meaning given the term in family therapy, which concerns the nature of what we know. It is proposed that the confusion can be diminished by understanding the relationship between the two meanings, which are here distinguished as epistemology (meaning 1) and epistemology (meaning 2) respectively. Particular attention is given to the logical consequences of adopting a position on epistemology (meaning 1)—e.g, is the knower capable of knowing an independent reality, or does the act of knowing make its own reality?—or on epistemology (meaning 2)—e.g., is causality linear or nonlinear?. The relevance and implications of these problems for the theory and practice of family therapy are discussed.
Making Family Therapy Easier for the Therapist: Burnout Prevention
Authors: FRIEDMAN ROBERT
Published: August 2004

Burnout prevention for family therapists can be enhanced by careful consideration of the degree of responsibility taken by the therapist contrasted with responsibility placed on the family. Attention to issues of expectations, role definition, sharing of feelings, and therapeutic ambition can ease the strain on the therapist.
A Systemic Approach to Couple Therapy
Authors: ELKAÏM MONY
Published: August 2004

This article presents a model of couple therapy based on the reciprocal double bind. Two cases are presented to illustrate the model, and different modes of intervention are described. This paper stresses that therapy has more to do with the intersection of the maps of the world of members of a system than it has with a search for some individual or systemic truth.
Quantifying Family Process:Issues in the Analysis of Interaction Sequences
Authors: COUSINS PETER C. , POWER THOMAS G.
Published: August 2004

The analysis of behavior sequences can be a useful technique for understanding family process and has been increasingly employed as a result of developments in family theory. Some of the most popular sequential analytic methods are reviewed, and problems of applying these methodologies to investigations of family interaction are discussed. Independence‐of‐observations, nonstationarity, and autocontingency are differentiated as three distinct types of serial dependence. In addition, issues concerning the choice of data type, analysis of low base rate behaviors, and the decision as to whether to correct for base rates are considered. Guidelines are presented for dealing with each of these issues in the context of the research or clinical question being addressed.
Systemic Research on Chronicity Factors in Infantile Asthma
Authors: ONNIS LUIGI , TORTOLANI DANIELA , CANCRINI LUIGI
Published: August 2004

This work is the result of research into chronicity factors in infantile asthma. The research had two main goals. The first, using a sample of 100 asthmatic children, was to reconstruct the therapeutic history of the individual patients on the hypothesis that the therapeutic intervention they had undergone in fact conditioned the quality of the cure demand. The second was to evaluate the influence of family dynamics on the chronic development of infantile asthma. A comparison was made between two interactive models using a sample of 10 families with asthmatic children with chronic tendencies and a sample of 10 normal families. The results show that typical dysfunctional interactive patterns exist in the experimental sample and that they are correlated with the perpetuation of the asthmatic symptom.

The paper concludes that every therapeutic intervention that is limited to dealing with the biological component of the asthmatic symptom and ignores the influence of family dynamics becomes itself a major chronicity factor. Thus a “systemic” intervention is considered necessary to prevent chronicity.
For God, Country, and Family: A Personal Tribute to Christian Fredrik Midelfort, M. D.
Authors: YOST JON L.
Published: August 2004

Christian Fredrik “Fritz” Midelfort, M.D. was born on October 23, 1906. He died on November 4, 1984 in his home in La Crosse, Wisconsin, some 90 miles from his birthplace of Eau Claire, Wisconsin. It was never his ambition as a family therapist to found a “school” or to obtain a following. As one of the pioneers in family therapy, his efforts spanned nearly 40 years. This tribute is intended to stimulate an appreciation for a remarkable family therapist, a seminal thinker, a devoted teacher, and a spirited Christian.
A Comparative Study of the Impact of Education vs. Process Groups for Families of Patients with Affective Disorders
Authors: ANDERSON CAROL M. , GRIFFIN SUZANNE , ROSSI ALBERT , PAGONIS IRENE , HOLDER DIANE P. , TREIBER RENATE
Published: August 2004

This clinical project compares the relative impact of two types of multiple family groups on psychiatric inpatients and their families. Forty patients with a diagnosis of affective disorder, and their family members, members, were randomly assigned to a traditional multiple family group with a process orientation that emphasized support, destigmatization, and self‐help about common problems; or to a psychoeducational multiple family group that emphasized the provision of information about the patient's illness and methods of coping with it effectively. Both groups, which met for four hours on a Saturday afternoon, were an integral part of an ongoing inpatient program specializing in the treatment of affective disorders. Pre‐ and post‐measures were obtained regarding family and patient knowledge about affective disorders, level of personal distress, attitudes about the illness, and dyadic adjustment. In addition, both patients and family members were asked to rate their satisfaction with the group experience. A number of differences in knowledge, attitude and dyadic adjustment were found in the participants of both groups immediately following their respective group sessions, but there were only a few statistically significant differences between the two groups. Those who attended the psychoeducational session, however, reported significantly more satisfaction with the experience.
Families with Physically Handicapped Children: Social Ecology and Family Systems
Authors: KAZAK ANNE E.
Published: August 2004

This paper reviews research on families with physically handicapped children, and integrates this work within a social ecological perspective. Methodological difficulties in past research that contribute to a lack of consensus in the area are discussed. Research on stresses experienced by various subsystems within families with handicapped children is presented, with recommendations for future family‐oriented research and intervention. The interactions of families with handicapped children with their social support networks are reviewed, underscoring the importance of these processes for coping and adaptation.
Circumplex Model VII: Validation Studies and FACES III
Authors: OLSON DAVID H.
Published: August 2004

This paper reviews some of the recent empirical studies validating the Circumplex Model and describes the newly developed self‐report measure, FACES III. Studies testing hypotheses derived from the Circumplex Model regarding the three dimensions of cohesion, change, and communication are reviewed. Case illustrations using FACES III and the Clinical Rating Scale are presented. These two assessment tools can be used for making a diagnosis of family functioning and for assessing changes over the course of treatment. This paper reflects the continuing attempt to develop further the Circumplex Model and to bridge more adequately research, theory, and practice.
Beginning Work with Families of Hospitalized Adolescents
Authors: Hanrahan Georgianna
Published: August 2004

This paper describes systemic issues that are central to the admission of an adolescent family member for inpatient psychiatric evaluation and treatment, and proposes ways in which family therapy on admission can offer opportunities for the growth, development, and autonomy of the adolescent, the family system, and the hospital system.
An Evaluation of an Intergenerational Consultation Process to Increase Personal Authority in the Family System
Authors: BRAY JAMES H. , WILLIAMSON DONALD S. , MALONE PAUL E.
Published: August 2004

This paper reports an evaluation of an intergenerational consultation process designed to help people change significant relationships in the three‐generational family system. The paper first describes the theory behind the consultation process that focuses on increasing personal authority in the family system; this is followed by a description of the consultation process. Clients who participated in the consultation process were compared to clients who participated in systems‐oriented psychotherapy. The results indicate that clients who participated in the intergenerational consultation reported significantly more change in intergenerational triangulation and personal authority than did the control group. There were no differences between the groups in reported change in presenting problems, satisfaction with therapy, or helpfulness of therapy. Persons who had their parents in the office for a consultation also reported significantly more change in personal authority and less intergenerational intimidation than did clients who did not have their parents in the office for consultation. Implications of these findings for intergenerational theory and therapy as well as future research are discussed.
Epistemology, Family Patterns, and Psychosomatics: The Case of Obesity
Authors: GANLEY RICHARD M.
Published: August 2004

A family systems model of obesity is developed that attempts to integrate systems epistemology, Minuchin's work on psychosomatic disorders, and a review of the literature on obesity. The model presents obesity as being inextricably embedded in relationship patterns that fundamentally influence its etiology and maintenance. It is argued that the emergent properties of these relationships need to be the focus of analysis, rather than the elementary components residing within the individual, which are emphasized in traditional theories of obesity. The radical shift involved in moving from the traditional mechanistic models to a systems perspective is also discussed because these approaches are based on different epistemologies. The fundamental differences between these epistemologies are important and often underemphasized, which has led to much confusion in past research. Based on the model developed here and supportive data from the obesity literature, the conclusion is reached that obesity research and treatment are likely to be advanced by adopting a systemic approach.
The Social Dynamics of Cigarette Smoking: A Family Systems Perspective
Authors: DOHERTY WILLIAM J. , WHITEHEAD D'ANN
Published: August 2004

This paper uses family systems concepts and the Family FIRO model to show how cigarette smoking occurs in the context of the important relationships in a smoker's life. Specifically, smoking is viewed as a way a person is included in relationships, is in control in relationships, and perhaps is intimate in relationships. When smoking is well‐established in the relationship, predictable interaction patterns surround it. When a person tries to quit or succeeds in quitting, these patterns change and may need to be replaced by nonsmoking alternatives. Partners may respond with support and willingness to create alternative patterns, or with undermining behavior stemming from a perceived threat to the established patterns. The model is offered for its heuristic value in guiding research and clinical experimentation. The paper also describes implications for family therapists as consultants to smoking‐cessation programs.
Leaving Home: Later Stages of Treatment
Authors: PERROTTA PETER
Published: August 2004

While the Leaving Home approach has greatly enhanced the work of many therapists struggling to help troubled young adults and their families, a more thorough consideration of the difficulties that often arise in the later stages of Leaving Home treatment is still needed. This paper examines the ways in which the function of the symptom and difficulties with lifecycle transitions may lead to problems in the later stages of treatment. Common manifestations of later‐stage problems, including loss of therapeutic focus and failure of parents to follow through on plans are examined. Direct and indirect strategies for addressing these problems are identified and guidelines for their use presented.
“If I Don't Get Simple, I Cry”
Authors: APONTE HARRY J.
Published: August 2004

Poor families have taught us special lessons that are applicable to all families. They have instructed us about the problems, within families, of developing relationships adequate to the tasks of family life. One consequence is that therapists are attending more to the evolution of the structure of family relationships, particularly, the phenomenon of underorganization. Poor families have also provided insight into the dynamic relationship between families and their social context. As a result, a therapeutic perspective is emerging that focuses on the influence of the community on the individual and the family, a perspective that may be called an eco‐structural approach to therapy.
Evaluation of Family Therapy Trainees: Acquisition of Cognitive and Therapeutic Behavior Skills
Authors: PULLEYBLANK ELLEN , SHAPIRO RODNEY J.
Published: August 2004

In this study, which describes the evaluation of a structural family therapy training program, we developed an evaluation procedure that can be used with other similar training programs. Trainees were evaluated before and after training as to their improvement in cognitive, case‐planning and in‐therapy intervention skills. Results suggest a progression of skill learning, beginning with cognitive understanding, followed by case planning, and then intervention skills. Though trainees made significant progress in cognitive and planning skills, this was not the case with intervention skills. Trainees' self‐evaluations were similar to their results on other measures.
Family Therapy with Delinquents: A Critical Review of the Literature
Authors: TOLAN PATRICK H. , CROMWELL RONALD E. , BRASSWELL MICHAEL
Published: August 2004

A critical review of the theoretical and outcome studies on family therapy with delinquents is presented. Assessment of the theoretical developments reveals that families of delinquents may be distinguishable from other families by their interactional sequences and processes. The available outcome studies within the field indicate that family therapy is viable for interventions with this population, with behavioral, structural, strategic, and communication approaches receiving the most support, but more specific and robust evidence is still needed. Trends in the research and critical issues are identified and used to provide suggestions for future research and practice.
Interventive Interviewing: Part I. Strategizing as a Fourth Guideline for the Therapist
Authors: TOMM KARL
Published: August 2004

A clinical interview affords far more opportunities to act therapeutically than most therapists realize. Because so many of these opportunities remain outside the therapist's conscious awareness, it is useful to elaborate guidelines that orient his or her general activity in directions that are liable to be therapeutic. The Milan associates defined three such basic guidelines: hypothesizing, circularity, and neutrality. Hypothesizing is clear and easy to accept. The notions of circularity and neutrality have aroused considerable interest but are not as readily understood. These guidelines may be clarified and operationalized when reformulated as conceptual postures. This process is enhanced by differentiating a fourth guideline, strategizing, which entails the therapist's decision making, including decisions about how to employ these postures. This paper, the first in a series of three, explores these four interviewing guidelines. The other papers will appear in a subsequent issue. Part II will focus on reflexive questioning, a mode of inquiry oriented toward mobilizing the family's own healing capacity. Part III will provide a scheme for analyzing and choosing among four major types of questions: linear questions, circular questions, reflexive questions, and strategic questions.
The Problem of Gender in Family Therapy Theory
Authors: HARE‐MUSTIN RACHEL T.
Published: August 2004

The field of family therapy is now a continuous process like a car cruising on automatic control with the driver comfortably in the lotus position. Family therapy theory rests on normative concepts of the traditional family and idealized conceptions of family relationships. Inequalities in the family associated with gender have been regarded as of little importance to the development of macro theory in the field. The two most influential therapeutic models, psychodynamic and systemic approaches, are each marked by gender bias. The alpha prejudice of psychodynamic theories exaggerates gender differences; the beta prejudice of systemic approaches ignores them.

The construction of gender role concepts has led to a false dichotomy, whether supported by traditionalists or feminists. On close examination, gender role ideals turn out to be simplifications and caricatures. The uncritical use of gender role concepts supports power differences between men and women and ignores the complexities and commonalities of human experience. The failure of family therapy theory to deal with gender issues needs to be addressed if a theory that is not just “more of the same” is to be developed.
Researching Ethnic Family Stereotypes
Authors: McGOLDRICK MONICA , ROHRBAUGH MICHAEL
Published: August 2004

Ethnic stereotypes in the family therapy literature make intuitive sense, but are based on surprisingly little empirical data. In a questionnaire survey of the family experiences of 220 mental health professionals representing eight American ethnic groups, most items differentiated the groups as predicted. A smaller, partial replication study comparing samples from Holland, Ireland, and North America found fewer discriminating items, but the differences that did appear were again as predicted. Implications for therapy and research with ethnic families are discussed.
Couples at Risk for Transmission of Alcoholism: Protective Influences
Authors: BENNETT LINDA A. , WOLIN STEVEN J. , REISS DAVID , TEITELBAUM MARTHA A.
Published: August 2004

A two‐generation, sociocultural model of the transmission of alcoholism in families was operationalized and tested. Sixty‐eight married children of alcoholic parents and their spouses were interviewed regarding dinner‐time and holiday ritual practices in their families of origin, and heritage and ritual practices in the couples' current generation. Coders rated transcribed interviews along 14 theory‐derived predictor variables, nine for the family of origin and five for the current nuclear family. Multiple regression analysis was applied in a two‐step hierarchical method, with the dependent variable being transmission of alcoholism to the couple. The 14 predictor variables contributed significantly (p < .01) to the couple's alcoholism outcome. A general theme of selective disengagement and reengagement for couples in families at risk for alcoholism recurrence is discussed.
Families of Adolescent Drug Abusers Are “Rigid”: Are These Families Either “Disengaged” or “Enmeshed,” or Both?
Authors: FRIEDMAN ALFRED S. , UTADA ARLENE , MORRISSEY MARGARET R.
Published: August 2004

The FACES instrument, based on Olson's Circumplex Model of family functioning, was administered to 96 adolescent drug‐abuse clients and their parents. The majority of these families categorized themselves as “disengaged” (rather than “enmeshed) on the cohesion dimension, and as “rigid” (rather than “chaotic”) on the adaptability dimension. These findings were unexpected as they were substantially different from published findings on families with other types of problems. Family therapists, utilizing Olson's Clinical Rating Scale for the Circumplex Model, characterized significantly more of these same families as “enmeshed,” rather than “disengaged.” rather than “disengaged.” Possible explanations for the difference between the therapists' perceptions and the families' self‐perceptions are discussed.
Professional Politics and the Concepts of Family Therapy, Family Consultation, and Systems Consultation
Authors: WYNNE LYMAN C. , McDANIEL SUSAN H. , WEBER TIMOTHY T.
Published: August 2004

At a time when an increasing number of professionals are calling themselves “family therapists,” many teachers and theorists in this field are troubled that the term “family therapy” no longer adequately characterizes the concepts or activities of the field. Recently, clinical, political, and economic circumstances have emerged that suggest the need for alternatives to the role of “family therapist.” By adding the roles of family consultant and systems consultant, we can open up new options for ourselves and our clients. During initial contacts with families, agencies, and other professionals, we can heighten our therapeutic potential by proceeding with consultative stocktaking, not starting with therapy. Family consultation also can assist in redirecting therapy when a new problem or an impasse develops, in focusing on competency rather than on pathology, and in engaging constructively with families that have a physically or mentally ill member.
Interventive Interviewing: Part II. Reflexive Questioning as a Means to Enable Self‐Healing
Authors: TOMM KARL
Published: August 2004

Reflexive questioning is an aspect of interventive interviewing oriented toward enabling clients or families to generate new patterns of cognition and behavior on their own. The therapist adopts a facilitative posture and deliberately asks those kinds of questions that are liable to open up new possibilities for self‐healing. The mechanism for the resultant therapeutic change in clients is postulated to be reflexivity between levels of meaning within their own belief systems. By adopting this mode of enquiry and taking advantage of opportunities to ask a variety of reflexive questions, a therapist may be able to augment the clinical effectiveness of his or her interviews.
Structure, Self‐Regulating Sequences, and Institutional Third Parties in Therapy: The Veterans Administration as a Model
Authors: FREY JOSEPH , SWANSON GREG , JACOB MELVIN
Published: August 2004

This article examines the structural organization and sequences of interaction among therapists, institutions, and patients and their families that contribute to the problem of institutional dependence. Our contention is that when patients have become dependent on an institution for the livelihood and/or for the stability it represents, they are only one part of a systemic relationship characterized structurally by enmeshed boundaries, and sequentially by self‐regulating feedback loops. We use this premise to outline the nature of the enmeshed transactions in patient‐therapist, patient‐institution, and therapist‐institution relationships. Family interfaces with this triad are also addressed. Sequentially, we outline the interactions among patient, family, therapist, and institution that lead to hierarchical incongruities. These sequences tend to produce self‐regulating feedback loops that perpetuate and maintain the structure of the system and its patterns of interaction. The final part of this article demonstrates how we strategically use a therapy team to manipulate the hierarchical incongruities and, hence, the recursive complementarity, that characterize the interactions between and among the members of this suprasystem. Besides manipulating the role of the therapist through team intervention, we also present several paradoxical and structural interventions that have been helpful when institutions have become third parties to therapy.
Marital Therapy Outcome Measured by Therapist, Client, and Behavior Change
Authors: CLINE VICTOR B. , JACKSON STEVEN L. , KLEIN NANCI , MEJIA JUAN , TURNER CHARLES
Published: August 2004

The present research examined marital therapy outcome, in a sample of 88 couples and 22 therapists, through the use of multidimensional criteria from multiple perspectives. Three paper‐and‐pencil patient self‐report instruments were used to measure different aspects of the couple relationship. In addition, therapist post‐therapy ratings and objective observer ratings of the couple behavior during therapy were obtained. Past debates about what the “right” criteria might be for measuring therapeutic change prompted our strategy. Special attention was focused on those criteria that could be classified as “inside” or “outside” of the couple relationship. Data analysis revealed a significant relationship between the couples' and therapists' ratings of improvement in therapy. Additionally, husband and wife negative acts (behaviors) in therapy were also significantly correlated with therapists' ratings of improvement. Both statistically significant and clinically significant criteria were employed to evaluate the therapy outcome. Improvement due to therapy as measured by the three self‐report instruments varied from 38% to 58%. These differences appeared to stem from the different kinds of information yielded by the specific tests.
Friends in Family Therapy: Use of a Neglected Resource
Authors: HABER RUSSELL
Published: August 2004

This article describes a rationale and methodology for expanding the therapeutic system to include clients' friends. Relevant literature and clinical research validate the resourcefulness of friends in dealing with the problems and developmental struggles from childhood to young adulthood. Examples are used to illustrate how consultation with friends can bridge generation gaps, provide positive peer pressure, foster increased perspective‐taking and empathy for all members of the family, challenge family enmeshment, provide support for the client in the therapeutic process, and provide helpful child‐management suggestions to parents based on the friends' experiences.
Epistemological Confusion in Family Therapy and Research
Authors: AUERSWALD E. H.
Published: August 2004

Family therapy began as a movement sparked by a small group of behavioral scientists who challenged the orthodoxies of medical and psychodynamic therapies. This movement signalled the beginning of an epistemological shift, the roots of which can be found early in this century in the physical sciences. As the field has grown and become for many a means of livelihood rather than an experimental thrust, though exploration of epistemological issues has continued, a split has developed in the field that mirrors the epistemological split currently visible in Western society. The predominant reality system of the Western world remains rooted in Cartesian/Newtonian, nineteenth‐century mechanistic and reductionistic “common sense,” even though the basis for a new, nonmechanistic and nonreductionistic reality system has been emerging in the twentieth century. The juxtaposition of both reality systems in the field of family therapy has produced much confusion. This article attempts to clarify the basis for that confusion.
Families and the Origins of Child Behavior Problems
Authors: DADDS MARK R.
Published: August 2004

This article reviews recent research into the relationship between family variables and child behavior. Although a diversity of factors may be associated with the development and maintenance of conduct/oppositional disorders in children, of primary importance are the moment‐to‐moment interactions that the child has with his or her primary caregivers. These are often marked by coercive, aggressive behaviors that may be functional for parents and children within the family system. However, the likelihood that parents will engage in coercive interactions with the child is also related to the latter's personal adjustment, which, in turn, is often dependent upon the parents' perceptions of the quality of marital and social support available to them. The goal for clinicians working with families of oppositional/conduct‐disordered children is to retain the demonstrated efficacy of direct intervention into parent‐child interactions while developing methods of assessment and treatment that attend to broader family variables, for example, marital discord, interfering in‐laws, and social isolation that may be functionally related to the occurrence of coercive parent‐child interactions.
Some Principles of an Ecological Model of the Person as a Consequence of the Therapeutic Experience with Systems
Authors: WILLI JÜRG
Published: August 2004

How do systems therapists' ideas of an individual differ from those of individually oriented therapists? Systems therapists are less interested in stable personality structures than in the contextual variability of a person's behavior. They think that although partnership may restrict, it also triggers the personality's development and shapes and models self‐realization. The coevolution of partners can neutralize neurotic dispositions and can have a healing effect. On the other hand, it is the individual who largely decides in what systems he or she will participate, and to what extent and in which manner. In modern, Western society, personal regulations through social systems are becoming increasingly weaker, and the possibility for individuals to realize themselves in interactions is more and more restricted. According to an ecological model of the person, self‐realization has to rely on relations to other persons in order to make it more real.
Toward a Generative Theory of the Therapeutic Field
Authors: GIACOMO DANIEL , WEISSMARK MONA
Published: August 2004

In the various models of family therapy, family systems are described as being patterned and programmed in their operations and development. The regularities and patterns found in family life are believed to be the expression of a program that determines the behavior of the family system and each of its members. Therapists holding this view will use “programming methods” in order to map family phenomena, and therapeutic work will consist of disrupting the problematic sequences in a deterministic way. However, if we take into consideration the impossibility of always linking inputs and outputs and the inability to evaluate consistently the behaviors in a system, problems associated with indeterminancy appear. Under such conditions, it may be impossible for therapists to formulate programs of family functioning. Therefore, we have operationalized a set of methodological principles that can be applied in such conditions. In this article we present the theoretical and practical implications for the field of therapy of “nonprograming methods.” A videotaped session is analyzed in order to show the application of the nonprogramming methods in clinical practice.
The Family Rorschach with Families of Schizophrenics: Replication and Extension
Authors: CARTER LINDA , ROBERTSON SUSAN R. , LADD JON , ALPERT MURRAY
Published: August 2004

Using a modified version of procedures outlined by Shapiro and Wild (9), this study evaluates the use of a Family Rorschach technique as a means of distinguishing families of schizophrenic patients from those of psychiatrically hospitalized, nonschizophrenic individuals. The patients were diagnosed using Research Diagnostic Criteria, and families were matched for age, intellegence, and socioeconomic characteristics. Results showed that the families with schizophrenic offspring scored significantly lower (that is, they had more communication and attentional difficulties) than those with nonschizophrenic offspring; offspring gender and family constellation had little effect on scores. Subsequent analyses indicated that lower scores were not simply a reflection of the psychoticism of the patient. These findings suggest that families of schizophrenics have interpersonal communication difficulties that compromise their ability to maintain a shared focus of attention. The findings are consistent with the suggestion that deviant patterns of family communication in interaction with genetic vulnerability in an offspring may result in the development of a schizophrenic disorder.
Interventive Interviewing: Part III. Intending to Ask Lineal, Circular, Strategic, or Reflexive Questions?
Authors: TOMM KARL
Published: August 2004

Every question asked by a therapist may be seen to embody some intent and to arise from certain assumptions. Many questions are intended to orient the therapist to the client's situation and experiences; others are asked primarily to provoke therapeutic change. Some questions are based on lineal assumptions about the phenomena being addressed; others are based on circular assumptions. The differences among these questions are not trivial. They tend to have dissimilar effects. This article explores these issues and offers a framework for distinguishing four major groups of questions. The framework may be used by therapists to guide their decision making about what kinds of questions to ask, and by researchers to study different interviewing styles.
Therapy for Families Manifesting Manic‐Depressive Behavior
Authors: WEBER GUNTHARD , SIMON FRITZ B. , STIERLIN HELM , SCHMIDT GUNTHER
Published: August 2004

This is a companion piece to the article “Some Features of Families with Major Affective Disorders,” published in Family Process (25: 325–336, 1986). In addition to the family features mentioned in the first article, the authors report on other features that have come to the fore since then. Subsequently, they deal with the therapeutic problems that derive from all of these features. In particular, they elaborate on how the therapists must (and can) maintain their neutrality in the face of the massive polarizations and extremes of the either/or thinking found in these families. There follows a description of typical phases in the therapeutic process. Finally, therapy with one family is described in detail.