摘要:

This study focused on the development of and changes in the interaction within a family after the onset of schizophrenia in a family member. Special attention is given to the possible effects of various treatments on the interaction. Our method was a circular interview of all family members in a joint session 8 years after the onset of schizophrenia. We observed that changes in family interaction usually had taken place during the first year of the illness. Thereafter, family conditions and interactions seem to have remained relatively unchanged. On the other hand, in addition to actual family‐centered therapy, all other treatment modes — individual therapy, medication, hospitalization — seemed to have acted as systemic interventions on the family level. Our observation that family interactions and models of therapy often had a surprisingly strong resemblance led us to consider the idea of their coevolution over the years and the possible significance of this. This article aims at calling the reader's attention to the manifold influences that the onset of schizophrenia and its various treatments seem to have had on family sy

ISSN:0014-7370    

DOI:10.1111/j.1545-5300.1989.00373.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Ethology offers psychiatry and family therapy an alternative perspective for understanding hierarchical dysfunction and individual psychopathology and the relation between them. Dominance and submission behaviors — descriptions from ethology — represent communicational mechanisms that play pivotal roles in maintaining the stability of the family group. When conflict becomes acute, dominant and submissive states are experienced as euphoria and mild depression respectively. Smooth functioning of these communicational mechanisms at the individual level enhances cohesion at the group level. Feelings of inadequacy and inferiority may be manifestations of submissive patterns and may function to maintain negative or corrective feedback loops, which preserve group stability. However, these communicational mechanisms may exhibit positive feedback runaway effects such that family crises result. These and other clinical implications of the model are explo

ISSN:0014-7370    

DOI:10.1111/j.1545-5300.1989.00387.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Evolution of the Family Systems Paradigm has been constrained by the dichotomy between theory building and empirical research. This article integrates these two domains by presenting a theoretical analysis of the “psychosomatic family” model as it informs and is informed by an empirical research project. Forty families of children with Crohn's disease (CD), ulcerative colitis (UC), and functional recurrent abdominal pain syndrome (RAP) were rated during standard, videotaped family interaction tasks, lunch, and interview. Laboratory scores of disease activity were associated with triangulation, marital dysfunction, and total “psychosomatic family” scores. Disease activity was not significantly correlated with enmeshment, overprotection, rigidity, conflict avoidance, or poor conflict resolution. Thus, the marital/triangulation and enmeshment/ overprotection/conflict clusters may be subcomplexes of the “psychosomatic family” complex. CD, UC, and RAP groups differed in the relations among particular family patterns and disease activity. A heuristic family‐psycho‐somatic model is presented to facilitate

ISSN:0014-7370    

DOI:10.1111/j.1545-5300.1989.00399.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

This is the second in a series of articles on an experimental, small‐sample study of systemic/strategic team consultations. It presents the 3‐year outcomes of clients whose 1‐month progress was described in an earlier report (12). The 8 therapists in the current study originally were asked to select two ongoing cases matched for difficulty (n = 16). While all cases continued their regular therapy sessions, one of each therapist's two cases were selected at random to participate in a “Milan‐in formed,” five‐part team consultation. At 3‐year followup, clients who participated in team consultations had maintained significantly higher levels of goal attainment than nonteam clients (p<.05). For interpreting these results, we propose a developmental theory (“emergent design”) to explain therapy impasses, team effects, the impact of termination, and long‐rang

ISSN:0014-7370    

DOI:10.1111/j.1545-5300.1989.00419.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

The Invariant Approach of Mara Selvini‐Palazzoli is a new development in the Milan approach to family therapy. In order to distinguish and explain it, an overview of the Invariant Approach is given. Jean Piaget's theory of cognitive development is used to provide a framework for explaining how Selvini‐Palazzo‐li's therapy alters the family's epistemology and facilitates change in the “family game.” It is suggested that family members in therapy tend to think about their problems in a style that resembles Piaget ‘s preoperational period. The process of therapy can be seen as geared to facilitate a shift from a preoperational to an operational style of cognitive functioning. This shift gives family members access to more adaptive ways of thinking about their problem‐solvi

ISSN:0014-7370    

DOI:10.1111/j.1545-5300.1989.00439.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

A 2‐year followup study was conducted to determine the efficacy and degree of satisfaction with Milan‐style family therapy with families refractory to other treatment interventions. Fourteen families and 5 couples who received Milan‐style family therapy participated in the study. Family outcome was found to be improved in 56% of parents and 89% of identified child‐patients at followup. Improved self‐outcome at followup was reported by 56% of fathers, 67% of mothers, and 78% of identified child‐patients. A substantial percentage of fathers (68%) and mothers (59%) reported that at least one family member sought further therapy posttreatment. Factors associated with either parent's positive perception of the treatment in general included the time interval between sessions, experiencing the treatment as brief rather than long, and positive feelings for the group behind the mirror. Mothers who reported liking the treatment reported better family outcome. For mothers, disliking the treatment was related to family members seeking further treatment. The more negative the mothers' and fathers' spontaneous comments about therapy were, the more likely that a family member would seek further alternative psychotherapy. The outcome results are explained in terms of the treatment families' negative reactions to some aspects of the therapist's stance and to the group behind the one‐way mirror, as in Milan‐style therapy. The importance of modifying Milan‐type therapy to foster a positive attitude toward the treatment procedures and the therapist's intervent

ISSN:0014-7370    

DOI:10.1111/j.1545-5300.1989.00457.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Typically, family therapy task interventions involve direct assignment of specific behaviors, which may or may not encourage client compliance. To enhance the clinician's probability of bringing about progress in treatment, this article broadens the parameters of task intervention to include (a) Direct versus Indirect, (b) Behavioral versus Nonbehavioral, and (c) Paradoxical versus Nonparadoxical dimension alternatives. The resulting 2 × 2 × 2 model, the Family Therapy Task Construction Paradigm, yields eight possible choices for end‐of‐the‐session punctuation. Each option is linked to corresponding treatment contexts and illustrated with examples from productive case vi

ISSN:0014-7370    

DOI:10.1111/j.1545-5300.1989.00471.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

ISSN:0014-7370    

DOI:10.1111/j.1545-5300.1989.00491.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY