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A psychosocial kinship model for family therapy.

Family therapy has traditionally centered on the nuclear family and thus has been typically oriented toward urban white middle-class families. A variety of modifications in therapeutic technique has evolved for work with the many modern families whose structure consists of a functional psychosocial family kinship. The authors have developed a formal theoretical framework and model for family therapy that encompasses the total psychosocial network, i.e., the extended kinships of the nuclear family and the functional kin such as friends, neighbors, and associates.

Family

Connectedness versus separateness: applicability of family therapy to Japanese families.

This article, a product of the two authors' multicultural experiences, contrasts British and Japanese families in order to examine the applicability of the Western model of family therapy to Japanese families and therapists. Areas where the Western model is incompatible are identified, and modifications to fit the Japanese indigenous model are suggested. The most significant difference in value systems between the two cultures is the Japanese preference for connectedness. The Japanese person is seen as a part of the embedded interconnectedness of relationships, whereas British norms prioritize separateness and clear boundaries in relationships, individuality, and autonomy. This value orientation is manifested in the Japanese language, hierarchical nature of the family structure, the family life cycle, and the implicit communication style. Systemic thinking, which deals with the pattern of relationships, is valid for all families regardless of cultural differences. But therapists should note that the preferred direction of change for Japanese families in therapy, is toward a process of integration--how a person can be effectively integrated into the given system--rather than a process of differentiation. An authoritative therapist style, the use of individual sessions, silence, and other nonverbal techniques are relevant to bringing about the desired change toward better integration of the individual with his or her networks.

Adolescent

A feminist approach to family therapy.

Although family therapy recognizes the importance of the social context as a determiner of behavior, family therapists have not examined the consequences of traditional socialization practices that primarily disadvantage women. The unquestioned reinforcement of stereotyped sex roles takes place in much of family therapy. A feminist therapy orientation that considers the consequences of stereotyped sex roles and the statuses prescribed by society for females and males should be part of family therapy practice. This paper describes the ways in which family therapists who are aware of their own biases and those of the family can change sexist patterns through applying feminist principles to such areas as the contract, shifting tasks in the family, communication, generational boundaries, relabeling deviance, modeling, and therapeutic alliances.

Communication

Introducing medical students to family therapy using simulated family interviews.

Small groups of medical students are introduced to the subject of family therapy using a technique involving the simulation of family interviews. The students are called upon to enact a situation in which family members visit their general practitioner with a problem relating to one of the children, and the diffusion of this problem within the family is traced during the course of the simulation. Discussion is focused on the feelings evoked by the simulation, the psychodynamics of the simulated family and the quality of the relationship between the general practitioner and the family as it arises out of the interview. An effort is made to help the students to get in touch with some of their feelings towards disturbed families and to mobilize these feelings towards the effective management of the family's problems. By role playing the general practitioner, students can prepare themselves for their future professional roles in a situation which allows for feedback from colleagues and experimentation. At the same time, when family members are role-played, the process of identification and empathy with patients is enhanced. The technique is potentially stressful because of the unusual demands that it makes upon the students in terms of personal involvement, but the experience derived from successive groups of students over a 2 year period has been consistently rewarding, and most students have expressed an enthusiastic interest in the exercise.

Adult

Family therapy in treatment of the deaf: a case report.

Deaf patients with psychological problems have developmental handicaps and clinical characteristics that reduce the effectiveness of traditional modes of psychotherapy. Attempts have been made to utilize individual and group therapy, but family therapy has been largely overlooked as a method of alleviating problems of the deaf. Clinical and research writings provide us with rich insights into the family dynamics of the deaf. These data suggest to the authors that the problems of deaf individuals are largely related to family problems, and therefore merit a family orientation as the focus for treatment. This paper describes an attempt to apply family therapy with a range of deaf patients over a period of two years. From a review of their work, the authors conclude that family therapy can be effective, particularly in the treatment of deaf adolescents and children.

Adolescent

Family therapy techniques for the family physician.

Since 1960, family therapy has emerged from the general field of psychotherapy as a discipline in itself. An extensive literature has been developed, much of it based on general systems theory. Family physicians have routinely recognized problem families within their practice. Skills and techniques are suggested in this article for introducing changes within a family system.

Adult

An index for measuring agency involvement in family therapy.

The Progress Index for Family Therapy Programs, an instrument for measuring the relative level of involvement in family therapy by treatment programs, is presented. It was developed as part of a national survey on the use of family therapy for treating drug abuse and includes data from 500 agencies, 76 of which were Community Mental Health Centers. The Index may be useful for assessing extent of family therapy involvement for differing agencies treating different populations.

Community Mental Health Centers

Designed experience: a multiple, goal-directed training program in family therapy.

A family-therapy training program, one of three main branches of the "Boston model," is described in detail. Salient features of the program include planned integration of a multiplicity of experiential and cognitive learning modes; grounding in a unified, theoretical framework that is neither eclectic nor limited to a single school of thought; focus on nonpathological process in families; and systematic structuring in terms of specific, articulated, training objectives. The goal-directed design process by which training units are developed is explained.

Affect

Family therapy and schizophrenia.

The early concepts of family influences in the development of schizophrenic illness have been reviewed. The empirical research which these concepts generated has failed in large measure to confirm many of these hypotheses, but has demonstrated reliable and valid differences between families of schizophrenics and those of patient and non-patient controls. However, these empirical findings have had little impact to date on family therapy as it is practised, and the failure to confirm theoretical concepts from psychoanalysis, systems, and communication theories has not led to a re-examination of family therapy and its theoretical basis. The author suggests that the empirical research on family influences in schizophrenia and particularly those factors which precipitate and perpetuate schizophrenic symptomatology can be applied to evaluation of schizophrenics and their families, specific family therapy with families of schizophrenics, and particularly suggest that evaluative research on the effectiveness of family therapy in schizophrenia will be necessary for family therapy to become more than a highly fascinating and experimental technique in the total management of schizophrenic patients.

Adult

Family therapy training: program and outcome.

A family therapy training program has been conducted for staff of mental health agencies located throughout Pennsylvania. This paper is a report on the content and results of the four-year-old training program. Three hundred practitioners have been trained in family therapy. The program has also led to the development of a core group of 64 family therapy trainers. There has been an associated delivery of more family-oriented mental health services throughout the Commonwealth.

Adult

The interaction of family therapy and psychodynamic individual therapy in an inpatient setting.

Although individual psychotherapy is an established treatment modality in psychoanalytically oriented hospitals, family therapy is a relative newcomer. When family therapy is introduced into such an inpatient setting, it raises issues which have not yet been widely discussed. On the one hand there is the question of how inpatient family therapy differs from outpatient family therapy, and what its special characteristics are. This question has only begun to be discussed. On the other hand there is the question of how family therapy relates to individual therapy that is being conducted simultaneously with a member of the same family. In general the individual psychotherapy literature tends to speak as if family therapy did not exist, and the family therapy literature speaks as if individual therapy should be abolished and supplanted by family therapy. Some authors have begun to try to build bridges between the two fields on the level of theory, but almost none have reported on the interaction between the two treatment modalities on a pragmatic level when they are conducted simultaneously (Kugel, 1974).

Adult

Introducing novice therapists to "go-between" techniques of family therapy.

The training of family therapists requires that learning objectives and expectations be specified in empirical terms so that the trainer and trainee can achieve clear goals, identify areas of progress, and meet the special needs of the trainee. This paper articulates the competencies, objectives, and criteria for evaluation used during a time-limited training program for therapists involved in family therapy research conducted at Centennial School of Lehigh University.

Family Therapy

Family therapy.

The discipline of family therapy, one of the psychotherapies, is defined and illustrated clinically in this article using case material. References are provided which allow further reading about family systems medicine.

Aged

[Family therapy in divorce].

A multi-generational approach to family therapy with divorce families is presented. Parents and children of such families are faced--with special problems during the phases of ambivalence, divorce and post-divorce. Their problems require varying focal points during therapeutic treatment. It focuses on arriving at a decision, finding constructive solutions for practical and emotional problems caused by the divorce ("psychic divorce" and parental cooperation concerning custody and education of the children) as well as supporting individuation and re-orientations. The main aim of therapeutic treatment is to alter the underlying pathogenic patterns of relationships and conflict-solving in order to prevent its repetition in a new partnership or in the next generation. Family therapy with divorce families is complicated to a high degree by aggressiveness, destructivity and resistance against working on central conflicts which serve to avoid feelings of anxiety, shame, guilt, anger and mourning.

Adaptation, Psychological

Family therapy after the divorce: developing a strategy.

Family therapy with the whole family after a divorce has taken place provides a unique opportunity for intervention. Though the spouses have legally terminated their relationship, their parenting function remains. However, this reality is often clouded by the emotional conflicts generated by the divorce. Family therapy can be useful in facilitating life in the post-divorce period. A four-part model for intervention is described. The first task is to redefine the family as existentially including all members. Next, generational boundaries are firmed in order to reduce the parentification process, often intensified by the parent's physical absence. Third, the family needs to have a replay of the history of the marriage to correct developmental distortions and offer a changce to mourn the loss of the intact family. Finally, the therapists attempt to facilitate an emotional divorce. A case study is presented to elucidate the manner in which these steps unfold in treatment.

Child Development

[Family therapy--encounters with a therapeutic fashion (author's transl)].

Following the boom in Group Therapy, the Federal Republic of Germany now experiences a similar boom in Family Thera;y. An attempt is made in the present article to show the stepwise progress from individual to group psychotherapy and finally to family therapy, and to describe and calssify the family therapy approach. The present family therapy boom is considered to be a kind of fashion. In the long run, however, family therapy as such will prove to be an important tool within the therapeutic spectrum. A cause for concern is the high demand made on the training and skill of family therapists. This deters those who had always considered family therapy as an integral part of their work in everyday paractice. This results in a plea for remaining close to actual practical conditions. The article close with recommendations for reading up relevant literature.

Family Therapy