ABSTRACTS OF LITERATURE

This is a clinical controlled study comparing the effects of “behaviorally” orientated family therapy, “client-centered” family therapy, and no therapy at all for families with a delinquent member. Sample included 99 families randomly assigned to treatments. Results indicated the efficacy of the behavioral family therapy in reducing recidivism.

This is a clinical paper that describes a process of selection of psychiatric residents, when both husband and wife are applicants. The selection procedure included a joint interview. Sample was six couples who applied. Outcome will be presented in a subsequent paper.

This is a research paper describing a type of feedback called “ascription,” which is defined as the therapist using a declarative statement to communicate information concerning a family member with whom he is interacting at the moment. Data were obtained from tape-recorded interviews with families by social workers. Five hundred twenty-six ascriptions were identified from 21 one-hour interviews. Each example was analyzed by three judges using questionnaires completed by the social workers. Of the 526 statements, 85 percent stimulated verbal responses from families. The therapist should know his purpose (for example, improving communication) in making the ascription. It is hypothesized that ascriptions produce changes in the family system if they bring the worker and the family together in a way that is “dynamic and meaningful to them both.”

This essay is focused on comparing family therapy to individual therapy from the point of view that “family therapy can be used as a method of preparing some patients for individual therapy or psychoanalysis.” Family therapy seems particularly indicated for “poorly individuated persons” defined as those: 1) whose egos are poorly defined, 2) who are unduly dependent, 3) who can't cope with intimacy, 4) who are usually psychotic or have a character disorder, 5) who act out intensively in psychoanalysis or psychotherapy, 6) who have the tendency for intrapsychic disruptive impact on the intrapsychic integration of another. A case is presented to illustrate some of the points made. Two short, critical discussions of the article are also presented.

This is an essay describing integration of a family therapy training program into a traditional training program for child psychiatrists that stressed psychoanalytic psychotherapy. Family therapy training was introduced because of failures in individual treatment, presence of multiple family problems, and families that were unable to “tolerate” prolonged evaluation and then individual treatment. The training program is described. It is suggested that family therapy is useful “especially with the disorganized, impoverished segment of our clinic population…. Teaching of the family therapy model does not interfere with learning of a psychoanalytic model.”

This is an essay based on data from the author's clinical practice describing various interpretations of silence in family therapy. Extensive silences increased the likelihood that the identified patient would drop out of family therapy. The more silent family members were, the less likely that the active member of the family would gain therapeutic benefit. Methods for managing silence in individuals and the whole family are described and a case example presented.

Four case reports are presented in support of the notion that conjoint family therapy is contraindicated when the identified patient is on the verge of decompensating, or has decompensated, or has recently recompensated from acute psychosis. It is hypothesized that the reason the identified patient gets worse in family therapy is because his anxiety increases and he is unable to express his discomfort when he becomes aware of his “ambivalent dependency” on his parents. If family therapy is used in such cases, it should be directive at first, then more insight-oriented later on when the patient's defensives are “more solidly reconstituted.”

This is a research study assessing the relationship among various measures of family power. Sample was 20 three-member normal families evaluated in terms of talking time, successful interruptions, an unrevealed difference technique, and a coalition game. Results indicated a positive relation between total talking time and successful interruptions, no relation between the coalition game and the unrevealed difference technique, and no relation between the process and outcome measures.

This is a review of the literature comparing (a) “normal” and “abnormal” families and (b) one or more diagnostic categories with normal controls or multiple comparisons. The focus was on hard-data, controlled studies. Methodological problems in these studies are discussed, and an extensive bibliography is included.

This is a critical article describing the use of behavior therapy in combination with family therapy. Method is to make base-line observations of family interactions for at least the first two weeks. Problem behaviors that need modifying are specified. A program manual describing methods of reinforcement, extinction, and of specifying behaviors to be recorded is presented. Results with eleven families indicated that significant changes occurred in deviant behaviors. One case example is given to illustrate this approach.

This is an extensive review of current knowledge on schizophrenia drafted by the National Institute of Mental Health. Included is a section on family dynamics and treatment. Recent investigations have shown the presence of pathological interaction in the families of schizophrenic patients. However, the nature of their relationship to schizophrenia is still unresolved. What is clear is that the kinds of “peculiar” communication that are found in the identified patient have also been found in the family of the schizophrenic.

This is a clinical paper describing a process in marital therapy in which one person is constantly pushed out of a dyad. Initially, one member of the couple and the therapist have “a thing” (defined as finding a point of contact between the therapist and one partner). This causes a change of equilibrium, and the therapist is brought closer to the other partner. In the final phase, the therapist is extruded and presumably the couple has established new patterns of relating, resolving the impasse that brought them into therapy. Advantages and disadvantages of this technique are discussed.

This is a clinical study of the reactions of wives to the myocardial infarction of their husbands. Sample was 65 wives of patients admitted to a general hospital who were interviewed without their spouses. Results indicated that during the immediate postcoronary period, the wives felt depressed and guilty and felt their marriages were more problematic. At one-year follow-up, most of these problems had disappeared.

This is a paper that discusses the family patterns of adolescent runaways, who are the identified patients. Four patterns of runaways are described: abortive runaways, schizoid runaways, casual runaways, and crisis runaways. Some runaways were expelled from the family, some kept bound to the family, and some were expected to fulfill different “missions” in the family (for example, to provide vicarious experiences for the parents). Suggestions for therapy are made.

This is an essay describing the use of marital art therapy for both the study and treatment of marital disorders. Advantages include immediacy, graphic representation of the couple's life, permanence, and “sheer pleasure.” A number of exercises are described including, for example, making a picture together, abstracting the marital relationship simultaneously but separately in a picture, and self-portrait exercises. Case examples illustrate the techniques.