Showing papers in "Family Process in 1983"

Circumplex Model of marital and family systems: VI. Theoretical update.

Abstract: This paper updates the theoretical work on the Circumplex Model and provides revised and new hypotheses. Similarities and contrasts to the Beavers Systems Model are made along with comments regarding Beavers and Voeller's critique. FACES II, a newly revised assessment tool, provides both "perceived" and "ideal" family assessment that is useful empirically and clinically.

Family models: Comparing and contrasting the Olson Circumplex Model with the Beavers Systems Model.

Abstract: There is an increasing interest in and need for family models. One such model is the Olson Circumplex Model, previously reported in this journal (18). This model is compared and contrasted with the Beavers Systems Model, which was also developed from empirical data and has had extensive use in family assessment. Though both are cross-sectional, process-oriented, and capable of providing structure for family research, we believe there are certain short-comings in the Olson model that make it less clinically useful than the Beavers Systems Model. These include definitional problems and a total reliance on curvilinear dimensions with a grid approach to family typology that does not acknowledge a separation/individuation continuum. Our model avoids these deficiencies and includes a continuum of functional competence that reflects the development and differentiation of many living systems, including the family.

Process, structure and world views: toward an integrated view of systemic models in family therapy.

Abstract: Therapeutic modalities centered in interpersonal processes, in structural phenomena, and in reality constructions--the three care orientations in the field of family therapy--are here defined as mutually nonexclusive "translations" of the systemic paradigm into clinical practice. This definition does not attempt to blur the distinctions among these models but seeks to show their common denominator and thus expands the conceptual and clinical repertoire of the systems-oriented family therapist.

The family and the child with epilepsy.

Abstract: Reports documenting psychosocial epiphenomena of chronic illness in individuals with that illness have been common in recent years. Few studies, however, have been concerned with how illness might affect the family. Those that have appeared in the literature often lack critical controls (i.e., control groups) and often fail to investigate possible links between illness-specific variables (i.e. chronicity, inhibition of mobility) and psychosocial outcomes on the family. The present study of 45 families focused on how children with epilepsy affect their families' functioning relative to families with a child with diabetes and families with no chronically ill members. The results suggest several areas of child and family adjustment (i.e. child self-concept, family communication, family cohesion) in which the families of epileptic children have great difficulty. Implications of these results are discussed with regard to differential influences of various chronic illnesses on families and family-based preventive and remedial treatment programs.

Anorexia nervosa: a transgenerational system perspective.

Abstract: In this paper it is suggested that there is a link between the condition of anorexia nervosa and certain rigid and implicit family beliefs. These rigid and implicit beliefs are transmitted from one generation to the next and have a highly constraining effect on all family members. More specifically, these beliefs include role prescriptions that are applied to certain daughters. These daughters are vulnerable to the symptoms of anorexia nervosa. The goal of treatment is to challenge successfully the constraining influence of these beliefs. As such beliefs appear extraordinarily resistant to direct challenge, this is best achieved by rendering the beliefs and their specific consequences explicit to family members. An intervention procedure based on this approach is described and its application to “anorectic families” is demonstrated. The description is supported by transcripts of a family in treatment.

Schizophrenia and the family: II. Adverse effects of family therapy.

Abstract: Theoretical formulations of the past thirty years have championed the hypothesis that family interaction contributes heavily to the etiology of schizophrenia, a position that has dominated contemporary family therapy even in the absence of solid empirical confirmation. The possibility that sociogenic modeling of schizophrenia is not only incorrect but even harmful to families, and to the relationship between families and clinicians, has never been taken seriously, despite its implications for the practice of family therapy. The author describes untoward effects of the sociogenic hypothesis in his own ten-year experience with families of chronic schizophrenics and examines pertinent reports in the family therapy literature, offering the reinterpretation that many communicational aberrations are adaptations to two therapist attributes: (a) failure to absolve the family of initial causal responsibility, and (b) failure to inform the family about the nature of the illness.

Multisystem‐Multimethod Family Assessment in Clinical Contexts

Abstract: A framework for assessing multiple levels of the family system by using multiple methodologies is proposed in this paper. This approach for measuring family phenomena is referred to as Multisystem-Multimethod (MS-MM) family assessment. Ideas from systems theory, measurement theory, and clinical application are used to describe the measurement strategy. A clinical case example is offered illustrating one way in which a MS-MM procedure can be implemented with families. Several currently available assessment tools are utilized to assess the individual, marital, and family levels of the family system. This diversity of measurement techniques provides convergent and divergent information within and across system levels. An MS-MM procedure has the capacity to assess the wholistic qualities of systems as well as specific issues within the boundaries of particular family subsystems.

Mourning is a family affair.

Abstract: Mourning is a process of social disengagement. In our modern society, however, the influence of social and religious institutions on the process of mourning has significantly diminished and been partially replaced by mental health clinics. Given the latter's penchant for the intrapsychic view, the perspective on mourning has become reduced to the individual. These trends are clearly reflected in a review of current literature and research on mourning. This paper proposes an interactional, systemic view of mourning through the analysis of two different families. Findings indicate that despite contextual differences between these two families, some basic commonalities render generalizations possible: (a) The selection of the identified patient is not coincidental to the stage of the family life cycle and to the role of the deceased member in the system. (b) Although death affects each individual differently, depending upon his or her relationship with the deceased, it continues to influence all family relations with equal powers. (c) Nonresolution of mourning permits a ghost to become an integral member of the family system. Examination of the treatment process demonstrates that a systemic approach is effective, even when individuals are interviewed alone.

Family Boundaries in Transition: A Search for Alternatives

Abstract: This paper attempts to clarify Minuchin's concept of family boundaries and to modify the original definition to one based on social systems concepts that are neutral with respect to pathology. The authors distinguish between logical and physical conceptualizations of "boundary" and differentiate the broad metaphor of family boundaries into proximity (i.e., interpersonal boundaries) and hierarchy (i.e., generational boundaries). Assuming that the nature of a relationship is reflected by the extent of overlap or sharing of interpersonal territories, Wood (14) adapted Goffman's (2) concept of territorial preserve to encompass six types of territories family members may share to a greater or lesser extent, reflecting the family's pattern of proximity. The family's hierarchy is reflected by who is "in charge," parents or children. We explore the process of boundary reorganization in families in transition, offering a nonstatic and health-oriented view of boundary permeability. Using the anthropological concept of "rite of passage," we suggest an alternative view of stressful transitional events such as marriage and divorce. We illustrate with examples the reorganization of proximity and hierarchy that occurs during periods of transition.

Live Supervision/Consultation: Conceptual and Pragmatic Guidelines for Family Therapy Trainers

Abstract: This paper addresses a conceptual and pragmatic gap in the area of family therapy training and supervision. It details an evolving stage-specific set of skills for the conduct of live supervision/consultation, using the previously developed conception of the isomorphic nature of training and therapy as a theoretical backdrop.

Multiple Theoretical Approaches to Supervision: Choices in Family Therapy Training†

Abstract: The supervision techniques used in structural, strategic, family-of-origin, and experiential family therapy training are discussed and compared, with emphasis on the isomorphism between supervision and therapy in each school. The usefulness of each supervisory model is related to supervisees' needs at different levels of training. Recommendations are made about the sequence of family therapy training, including the utility of eclectic versus purist family therapy training programs for trainees at different levels of experience.

Material, Myth, and Magic: A Cultural Approach to Family Therapy

Abstract: This paper presents a model for a therapeutic approach to the cultural systems of families. Using anthropologically derived concepts of material and ideational planes of culture, magic, and ritualistic intervention, the inducement of culture change in frozen familial systems is framed in dialectical terms. Four brief case studies are presented describing the systems engaged, the material-ideational rituals employed, and the cultural transformations induced. The paper concludes with a brief discussion of some of the theoretical and practical implications of this cultural approach to the family in therapy.

An Institution for Change: Developing a Family Day Unit

Abstract: This paper describes the theory and structure of a day unit designed to intervene in the systems of families who present with severe or multiple problems to agencies attempting to help them, but who are difficult to engage in a therapeutic pact and unresponsive to attempts at outpatient therapy. An analysis of these families is offered in terms of the relations between internal and external boundaries and difficulties in making transitions in the daily contexts of life. The principles of the unit are described in terms of the creation of an artificial extended family, the intensification of sequence and patterns of interaction, and the making and traversing of boundaries. Particular attention is paid to the function of agency interventions in family patterns and to redefining the relationship between family and agencies.

Contrasting strategic and Milan therapies.

Abstract: Three related models of therapy are often grouped together as the strategic therapies. These are the brief therapy model associated with the Mental Reseach Institute, approaches developed by Jay Haley and Cloe Madanes, and the model developed by the Milan associates. Controversy exists, however, as to whether the Milan model should be included as a strategic therapy. It appears that the similarities among the three models can mask deeper differences, thus confounding the confusion. This paper contrasts the models in their development, theory, and practice.

Rules: the invisible family.

Abstract: Family rules occur in groups of five and more. Because they are implicit and multi-dimensional, family rules are beyond visualization. These characteristics have unsettling effects on clinicians and researchers. Knowing the rules of a family, however, allows precise intervention, and using rules concepts makes learning family therapy techniques less threatening to students. The concept of homeostasis in the context of rules has been examined and placed in an understandable perspective. Rules provide the connection between family process and individual behavior. They also constitute an integrated theory of families and individual personality development.

Joint Custody: Parental Problems and Satisfactions

Abstract: Joint custody, the total care of children by each parent part of the time, enables both parents to be "custodial" parents after divorce. Increasingly it has become a solution to custody problems, allowing both parents major involvement in their childrens' lives as well as freedom for themselves. This research addresses joint custody from the parents' perspective, exploring the salient issues. The problems and satisfactions are discussed, and the sex differences are highlighted.

Agency Triangles: Problems in Agency‐Family Relationships

Abstract: This article focuses on ways in which helping agents, including family therapists, become part of the problem they are treating. Particular emphasis is placed on triangular patterns that frequently develop when one agency involves another in carrying out its functions and in diffusing conflict with a client and his or her family. We refer to this process as an agency triangle. Case examples of such triangles involving various service systems (e.g., schools, courts, mental health centers) are presented, followed by discussion of how agency triangles can be prevented.

Assessing the Development of Relationships: A New Measure

Abstract: This paper describes the development and application of a procedure (The Relationship World Index) to measure the development of intimate relationships. Grounded in symbolic interaction theory, the Relationship World Index is a measure of agreement on important aspects of relationships between members of intimate dyads. The development of the measure was guided by assumptions inherent in symbolic interactionism that predict the emergence of a shared construction of reality that bonds relationship members. Research results are presented providing evidence for the reliability and validity of the measure.

Why can't I get hives: brief strategic therapy with an obsessional child

Abstract: A case study is presented of a 10-year-old boy who obsessively feared he would vomit. The material is formulated within a psychodynamic as well as a strategic model, and treatment approaches are suggested for each. The treatment consisted of a five-session, strategic, problem-focused approach over three months with a two-year follow-up. The rationale and effective ingredients of the intervention are discussed.

Assessment of Perceptual Discrepancy: Utility of the Primary Communication Inventory†

Abstract: The Primary Communication Inventory was factor-analyzed in order to validate the subscales of this instrument. These subscales were derived by Navran (20) on the basis of face validity and were labeled verbal and nonverbal communication subscales. The analysis yielded two factors. However, they could not be labeled verbal and nonverbal. Instead, the factors were interpreted as: (a) the individual's perceptions of own communication ability, and (b) the spouse's perceptions of the individual's communication ability. The scoring of the Primary Communication Inventory was revised and used as a measure of perceptual discrepancy between husbands and wives. Interestingly, discrepancy within the marital dyad was greater for the nondistressed participants than for the distressed participants. The results illustrate the potentially adaptive nature of positive perceptual distortion within the marital dyad and the potential utility for future research of calculating perceptual discrepancy scores for each spouse using the Primary Communication Inventory.

Spouse-aided versus individual therapy in persisting psychiatric disorders: a systematic comparison.

Abstract: Fifty-three married patients with a wide range of severe, persisting psychiatric disorders were randomly allocated to a form of couples therapy (spouse-aided therapy) or to individual therapy. Both were outpatient, goal-oriented therapies, with an overall mean duration of 9.5 hours. Before, during, immediately after, and three months after therapy, patients and spouses completed ratings of target and personal problems, sexual activity and attitudes, psychological symptoms, and marital satisfaction. Ratings were also conducted by independent assessors. Spouse-aided therapy proved superior to individual therapy at a statistically significant level on most outcome measures, with clinically worthwhile improvements in symptoms, problems, and marital satisfaction in both partners. Individual therapy was followed by improvement in some symptoms, but marital dissatisfaction increased and both partners were more depressed at three months follow-up than before treatment.

Jealousy: Interventions in Couples Therapy

Abstract: Jealousy is a ubiquitous phenomenon that often needs to be addressed in couples therapy. Eleven treatment interventions, with case examples, are discussed, ranging from traditional, direct, straightforward approaches to indirect, paradoxical solutions. Criteria are offered for determining which interventions to use.

Family treatment of an obsessive-compulsive child: a case report.

Abstract: This paper presents a family therapy approach to the treatment of an obsessive-compulsive child. Psychodynamic, behavioral and family therapy approaches to the etiology and treatment of this dysfunction are described briefly, and a detailed case report of a 15-session treatment utilizing behavioral interventions designed to change the family context is presented. Various procedures for dealing with the obsessive-compulsive behavior have been reported in the literature, including eliminating it directly by interruption or ordeal and modifying it. In this case, the author proceeded by ignoring the compulsive behaviors and concentrating on more functional ones using a paradoxical charting intervention. At one-year follow-up, the child was symptom free. Relationship factors, technical interventions, and stylistic aspects of the therapy are discussed, and the importance of rapid symptom alleviation in these children is underscored.

Perceptions of family environment among psychiatric patients and their wives.

Abstract: This study compared the perceived family environments of former psychiatric inpatients with thought, affective, and substance abuse disorders to those of normative comparison couples using the Family Environment Scale. Family environment was assessed among patients and wives separately at hospital discharge and at three- and twelve-month follow-ups. Patients and their wives were consistently more incongruent in their perceptions of their shared environment than normative couples. In addition, low-functioning patient couples reported less family cohesion, expressiveness, and recreational emphasis than their higher functioning counterparts; the high-functioning patient couples more closely resembled the norm. The paper discusses possible relationships between positive family contact and better patient functioning.

Getting and Giving Information: Analysis of a Family-Interview Strategy†

Abstract: This paper reports on a videotape study of particular aspects of the two-part interview developed by Selvini-Palazzoli et al. (8, 9). The first segment is a "search for information," the second part the application of an intervention based on the information gathered in the first part. The study focused on the strategies of information retrieval on the premise that they are significant for the quality of information gathered and for the criteria implicitly conveyed by the therapist that in turn have their own substantial impact on the system. We have employed theories of communication, particularly conversational analysis, that are a departure from the epistemological premises of systems theory and communication pragmatics proposed by Selvini-Palazzoli et al. as the theoretical underpinning of their interview technique.

Sensory experience and family process: perceptual styles tend to run in but not necessarily run families.

Abstract: The science of family systems has begun to develop concepts and methods for objectively assessing important characteristics of families. Thus we now have ways of measuring differences among families with respect to cohesiveness, flexibility, clarity of communication, and shared views of social reality. We know practically nothing, however, about the origins of these differences among families. One possibility is that the skills or personal attributes of one or more individual members influences the characteristics of the family as a whole. This paper explores the hypothesis that the perceptual styles of individual members — the ways they organize their experience of their personal stimulus world — influence the shared perceptions the family develops of the social world in which it lives. We explored relationships between nine measures of perceptual style and problem-solving measures of the family's shared perception of its social world. The findings showed many similarities among members of the same family on several measures of perceptual style. However, perceptual style had only a few relationships with family performance in the problem-solving task.

Communication styles and marital satisfaction in Israeli and American couples.

Abstract: This study examined the conflict-related communication styles of American and Israeli couples and how these communication styles related to marital satisfaction in the two groups. An Israeli sample was recruited from Israeli couples currently living in New York City; the American sample was selected from the friendship circles of the Israeli couples. In spite of the close social ties of the two groups, we predicted that the conflict-related communication styles of the Israelis would be less calm and rational than those of the Americans and that such rational modes of communication would be positively associated with marital satisfaction for the Americans but not for the Israelis. The principle instruments were Straus' Conflict Tactics Scale, Ryder's Imagined Situation Inventory, and Spanier's Dyadic Adjustment Scale. Results largely confirmed the hypotheses. Israeli couples were more apt to be verbally aggressive (but less physically violent) and less apt to behave calmly during marital conflict, but these communication styles did not relate to marital satisfaction as strongly for the Israelis as for the Americans. These findings are discussed as a demonstration of the importance of considering cultural context when treating families.