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PubMed1977

A systems theory approach to a case of anorexia nervosa.

Systems theory views mental and psychosomatic illness as the natural consequences of a dysfunctional human interactional group. The symptom chosen is affected by the symptom carrier's age, sex, and unique individual characteristics. However, the reason the symptom develops and is maintained is to be found in the system(s) of which the symptom carrier is a part. A human system consist of two or more individuals who have an ongoing, often goal-directed, relationship with each other. The most important human system today is undoubtedly the family. The welfare of the individual is usually related to membership in a vital, well-adjusted family. A dysfunctional family easily becomes dependent on mental or behavioral deviations in one of its members as a means of preventing disintegration. We hope this article's description of a typical treatment situation will demonstrate how a systems theory approach differs from other forms of family therapy in its evaluations and techniques.

Adolescent↗
PubMed1980

The Greek chorus and other techniques of paradoxical therapy.

This paper has described some of the interventions developed at the Ackerman Brief Therapy Project in treating the families of symptomatic children. The interventions are based upon a differential diagnosis of the family system and upon an evaluation of that system's resistance to change. They are classified as compliance-based or defiance-based, depending upon the family's degree of anxiety, motivation, and resistance. Paradoxical interventions, which are defiance-based, are used as a clinical tool in dealing with resistance and circumventing the power struggle between therapist and family. A consultation group acting as a Greek chorus underlines the therapist's interventions and comments on the consequences of systemic change. This group is also sometimes used to form a therapeutic triangle among the family, therapist and group, with the therapist and group debating over the family's ability to change.

Child↗
PubMed1980

The use of paradox in a community home for the chronically disturbed and retarded.

This paper describes the use of paradoxical interventions to change the resistant behaviors of community home residents who were formerly institutionalized in state hospitals and in state schools for the retarded for an average of 27 years. The paradoxical interventions were used following prior therapeutic failures using more traditional behavioral approaches. Seven brief case studies are presented describing the problem, the paradoxical intervention used, reactions to the intervention, follow-up information, and an explanation of the intervention. Some of the paradoxical interventions used include: prescribing the resistance, symptom, or system; reframing; restraining change; reversals; and rituals. Explanations of these interventions are given based upon general systems theory.

Adult↗
PubMed1980

Some cotherapy techniques with families.

The use of cotherapists in family therapy is explored with particular attention to the unique ways in which this form of therapy can aid the therapeutic process. A basic cotherapy transactional pattern is described, and a number of techniques specifically for use in cotherapy with families and couples are discussed.

Communication↗
PubMed1987

The reflecting team: dialogue and meta-dialogue in clinical work.

A "stuck" system, that is, a family with a problem, needs new ideas in order to broaden its perspectives and its contextual premises. In this approach, a team behind a one-way screen watches and listens to an interviewer's conversation with the family members. The interviewer, with the permission of the family, then asks the team members about their perceptions of what went on in the interview. The family and the interviewer watch and listen to the team discussion. The interviewer then asks the family to comment on what they have heard. This may happen once or several times during an interview. In this article, we will first describe the way we interview the family because the interview is the source from which the reflections flow. We will then describe and exemplify the reflecting team's manner of working and give some guidelines because the process of observation has a tendency to magnify every utterance. Two case examples will be used as illustrations.

Adult↗
PubMed1981

Some practical points concerning psychotherapy in the integrated treatment programme during the first 3 months in hospital. Comments on the three detailed descriptions of psychotherapy with schizophrenics.

Some previous studies of individual and group psychotherapy in schizophrenia are presented. A team consisting of a main therapist (usually a specially trained psychologist or social-worker), who works closely with a group leader (usually a specially trained mental nurse) was developed. Together they carried out and monitored the integrated treatment programme in hospital. This programme included intensive psychotherapy, social training, ADL training and a system for evaluation of the treatment process when combined with neuroleptics. Some practical points concerning individual and group psychotherapy with schizophrenics during the first 3 months in hospital are presented. This treatment has been carried out on a routine basis for the last 7 years.

Humans↗
PubMed1977

Couples group therapy as an adjunct to lithium maintenance of the manic patient.

Use of couples therapy groups in conjunction with lithium in the long-term management of married manic-depressive patients is described. Among bipolar patients on lithium, those in couples group therapy had more benign posthospital course than those given minimal support beyond medication. The structure and benefits of the couples group are discussed.

Adult↗
PubMed1977

A family therapy outcome study in an inpatient setting.

A small sample of adolescents hospitalized in a public mental health facility received family therapy while a control group received individual therapy. Follow-up at three months indicated that those treated in family therapy returned to functioning more rapidly and were rehospitalized less frequently than adolescent patients in individual therapy. Directions for further study are suggested

Adolescent↗
PubMed1977

Adolescent day treatment: a community alternative to institutionalization of the emotionally disturbed adolescent.

This paper describes the need, the formation, and the structure of a partial day treatment program for severely disturbed adolescents, which uses local resources to maintain clients in the community. Components of the program, including family therapy in the home, are outlined and case illustrations are offered. Applications to other community settings are discussed.

Adolescent↗