FAMILY THERAPY : Concepts, Process and Practice by Alan Carr – 2nd ed. pdf
a broad term given to a range of methods for working with families with various biopsychosocial difficulties. Within the broad cathedral of family therapy there is a wide variety of views on what types of problems are appropriately addressed by family therapy; who defines these problems; what constitutes family therapy practices; what type of theoretical rational undepins these practices; and what type of research supports the validity of these practices.
Some family therapists argue that all human problems are essentially relational and so family therapy is appropriate in all instances. Others argue that marital and family therapy are appropriate for specific relationship problems or as an adjunct to pharmacological treatment of particular conditions, such as schizophrenia.
Some family therapists argue that problems addressed in therapy are defined by clients, that is, parents, children or marital partners seeking help. Others argue that problems are best defined by professionals in terms of psychiatric diagnoses or statutory status, such as being a family in which child abuse has occurred and on an at-risk register, or being a person with an alcohol problem on probation.
With respect to practices, some family therapists invite all family members to all therapy sessions. Others conduct family therapy with individuals, by empowering them to manage their relationships with family members in more satisfactory ways. Still others have broadened family therapy so that it includes members of the wider professional and social network around the family, and may refer to this approach as ‘systemic practice’.
There are many theories of family therapy. Some focus on the role of the family in predisposing people to developing problems or in precipitating their difficulties.
Others focus on the role of the family in problem maintenance. But all family therapists highlight the role of the family in problem resolution. There is also considerable variability in the degree to which theories privilege the role of family patterns of interaction, family belief systems and narratives, and historical contextual and constitutional factors in the aetiology and maintenance of problems.
With respect to research, some family therapists argue that case studies or descriptive qualitative research provides adequate support for the efficacy of family therapy. On the other hand, some family therapists highlight the importance of quantitative results from controlled research trials in supporting the degree to which family therapy is effective in treating specific problems.
Within this volume, an integrative and developmental approach will be taken to family therapy, and where better to start than with a consideration of family problems across the lifecycle. Family problems occur across all stages of the lifecycle. Here are some examples:
• A six-year-old child whose parents cannot control him and who pushes his sister down the stairs.
• A 13-year-old girl who worries her parents because she will not eat and has lost much weight.
• A 19-year-old boy who believes he is being poisoned and refuses to take prescribed antipsychotic medication.
• A couple in their mid-30s who consistently argue and fight with each other.
• A blended family in which the parents have both previously been married and who have difficulties managing their children’s unpredictable and confusing behaviour.
• A family in which a parent has died prematurely and in which the 13-year-old has run away from home.
• A family in which a child is terminally ill and will not follow medical advice.
• A family with traditional values in which a teenager ‘comes out’ and declares that he is gay.
• A family in which both parents are unemployed and who have difficulty managing their children without getting into violent rows.
• A black family living in a predominantly white community, where the 16-year-old boy is involved in drug abuse in a delinquent peer group.
These are all complex cases that involve or affect all family members to a greater or lesser degree. A number of these cases also involve or affect members of the community in which the family lives. In some of the cases listed, other agencies, including schools, hospitals, social services, law enforcement, juvenile justice or probation, may be involved. Family therapy is a broad psychotherapeutic movement that offers conceptual frameworks for making sense of complex cases such as those listed here and entails approaches to clinical practice for helping families resolve complex problems.