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Family Process
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Family Process Heft 1/2001
1/2001 - 2/2001 - 3/2001 - 4/2001 - Überblick

Anderson, Carol M. (2001): An Update for the Real New Millennium. In: Family Process 40(1): S. 1-3

Rosenfarb, Irwin S., David J. Miklowitz, Michael J. Goldstein, Lisa Harmon, Keith H. Nuechterlein & Margaret M. Rea (2001): Family Transactions and Relapse in Bipolar Disorder. In: Family Process 40(1): S. 5-14.

abstract: This study examined whether patient symptoms and relatives' affective behavior, when expressed during directly observed family interactions, are associated with the short-term course of bipolar disorder. Twenty-seven bipolar patients and their relatives participated in two 10-minute family interactions when patients were discharged after a manic episode. Results indicated that patients who showed high levels of odd and grandiose thinking during the interactions were more likely to relapse during a 9-month followup period than patients who did not show these symptoms during the family discussions. Relapse was also associated with high rates of harshly critical and directly supportive statements by relatives. Patients' odd thinking and relatives' harsh criticism were significantly more likely to be correlated when patients relapsed (r =.53) than when they did not relapse (r =.12). Results suggest that bipolar patients who show increased signs of residual symptomatology during family transactions during the post-hospital period are at increased relapse risk. The data also suggest that relatives of relapsing patients cope with these symptoms by increasing both positive and negative affective behaviors. Moreover, a bidirectional, interactional relationship between patients' symptoms and relatives' coping style seems to capture best the role of the family in predicting relapse in bipolar disorder.

Rohrbaugh, Michael J., Varda Shoham, Sarah Trost, Myra Muramoto, Rodney M. Cate & Scott Leischow (2001): Couple Dynamics of Change-Resistant Smoking: Toward a Family Consultation Model. In: Family Process 40(1): S. 15-31.

abstract: Smoking is North America's leading cause of preventable morbidity and mortality. Although effective cessation treatments exist, their overall effect is modest, and they rarely reach the high-risk, health-compromised smokers who need them most. Surprisingly, despite evidence that marital relationship variables predict the success of cessation efforts, family systems ideas have had little impact on current intervention research. We review and critique the cessation literature from a systemic viewpoint, illustrate two couple-interaction patterns relevant to the maintenance of high-risk smoking, and outline a family-consultation (FAMCON) intervention for couples in which at least one partner continues to smoke despite having heart or lung disease. Taking into account ironic processes and symptom-system fit, FAMCON focuses on the immediate social context of smoking, aiming to interrupt well-intentioned "solutions" that ironically feed back to keep smoking going, and to help clients realign important relationships in ways not organized around tobacco usage. Currently in its pilot-testing phase, FAMCON is an adjunctive, complementary approach designed to include collaboration with primary-care physicians and to make smokers more amenable to other, evidence-based cessation strategies.

Penn, Peggy (2001): Chronic Illness: Trauma, Language, and Writing: Breaking the Silence. In: Family Process 40(1): S. 33-52.

abstract: In our work with families that struggle with a chronic illness, we have relied on three ideas. First, we regard illness as a relationally traumatizing experience, not just for the person with the illness, but for other members of the family as well. We use the phrase "relational trauma" because of its effects on members of a wider system who also show signs of physical stress, isolation, and helplessness (Sheinberg & Fraenkel, 2000). Our second concern is how the conversation that leads to new stories is expanded through the development of voice and the use of writing. Looking at language, we are particularly attentive to the social prevalence of negative metaphors that surround and engulf the ill person and her family: dependence, poor genes, repressed personalities, weak constitutions, et cetera (Sontag, 1984). These negative metaphors, or outside voices, join with the inner voices of the ill person and result in a silence that disconnects people at a time when connections must be relied on and above question. Our third emphasis is on the use of writing as the means to create new voices, metaphors, and multiple descriptions that can reinvigorate the conversations silenced by the illness. Once the family's voices are reconstituted through writing, the emotions that have been displaced by the illness are restored to their conversation. I have included new research from JAMA detailing the treatment of patients with chronic illness through their use of writing. I was 43 years old, a practicing, licensed psychologist for over 25 years, and happily married to the man with whom I was raising a 14-year-old son and an 11-year-old daughter. I had just finished one year of treatment for cancer, a treatment the noted surgeon, Dr. Susan Love [citation omitted] refers to as "slash, cut, and burn." My life was bleak and lonely because I lived in silence: certain that no one could bear to hear the feelings and thoughts I had following my year of treatment; unwilling to find out if I was right; certain that I needed to protect people from my experiences; and failing in those few times that I tried to put into words the chaos of my emotions and the terror that lived in my flesh. - Kaethe Weingarten (2000, p. 390)

Omer, Haim (2001): Helping Parents Deal With Children's Acute Disciplinary Problems Without Escalation: The Principle of Nonviolent Resistance. In: Family Process 40(1): S. 53-66.

abstract: There are two kinds of escalation between parents and children with acute discipline problems: (a) complementary escalation, in which parental giving-in leads to a progressive increase in the child's demands, and (b) reciprocal escalation, in which hostility begets hostility. Extant programs for helping parents deal with children with such problems focus mainly on one kind of escalation to the neglect of the other. The systematic use of Gandhi's principle of "nonviolent resistance" allows for a parental attitude that counters both kinds of escalation. An intervention is described, which allows parents to put this principle into practice.

Ryan, Dermot & Alan Carr (2001): A Study of the Differential Effects of Tomm's Questioning Styles on Therapeutic Alliance. In: Family Process 40(1): S. 67-77.

abstract: To replicate and extend Dozier's (1992) test of Tomm's hypothesis about the differential effects of questioning styles on therapeutic alliance, an analogue study was conducted. Twenty-eight family triads, each including a son and his parents, viewed four videotaped, simulated family therapy scenarios in which Tomm's four questioning styles were separately portrayed. Participants were asked to identify with the client whose role corresponded to theirs (that is, father, mother, or son) and, on the basis of this, to rate the client's alliance with the therapist. They were also asked to rate the overall alliance between the family and the therapist. Finally, having viewed all four scenarios, they were invited to rate comparatively the quality of the therapeutic alliance across the four questioning styles. Compared with strategic and lineal questioning styles, circular and reflexive questions led to higher ratings of therapeutic alliance on all three measures. The results of this study support Tomm's hypothesis that questioning styles based on circular assumptions lead to a better therapeutic alliance at an individual and systemic level than do questions based on lineal assumptions.

Androutsopoulou, Athena (2001): The Self-Characterization as a Narrative Tool: Applications in Therapy with Individuals and Families. In: Family Process 40(1): S. 79-94.

abstract: In this article, I argue that the use of Kelly's self-characterization can aid story telling in therapy. It describes the use of the tool's original instructions, and of two other versions (the ideal self in 5 years time and the family characterization sketch), with individuals and families. In contrast to Kelly's practice, clients' written self-descriptions are not stripped to uncover cognitive schemata, but are treated as whole narratives. The texts are collaboratively analyzed, by looking at both their form and content. The cases presented illustrate ways in which these narratives can be read to help therapists recognize a person's/family's language "codes" and transgenerational family themes. "Warded off areas of feeling" are opened up, and differentiation from dominant family voices is facilitated. The whole technique process reveals the great importance people place on negotiating, editing, and finally presenting a narrative 1 that portrays the way the self and the family are experienced at that particular time (see Endnotes).

Sveaass, Nora & Sissel Reichelt (2001): Engaging Refugee Families in Therapy: Exploring the Benefits of Including Referring Professionals in First Family Interviews. In: Family Process 40(1): S. 95-114.

abstract: The possible benefits of including referring professionals in the first family interviews are being explored as a way to engage refugee families in therapy. Families in exile confront a number of problems related both to premigration traumatic exposures and to present adaptation processes. Refugee clients and the referring professionals in the larger system frequently see the problems and their solutions quite differently. This situation may often result in unclear working alliances in a context of therapy. We will describe first family interviews in which referring professionals are interviewed about their reasons for referrals, and where the families are invited to discuss these considerations. The conversations permit families, referrers, and therapists to reflect upon differences in positions and perspectives. Their experiences suggest that agreements or contracts based on these joint interviews are less ambiguous and more clearly formulated than contracts based on interviews with families alone. Finally, these experiences are discussed as a potentially valuable approach in a cross-cultural context.

Greeno, Catherine G. (2001): Introduction to the Technical Series: What is Science, and How Does It Help Us? In: Family Process 40(1): S. 115-120.

abstract: Editor's Note: Readers trained in research have no need of a series of articles that introduce the value of the scientific method and the basic factors that comprise good research methodology. But readers who are primarily trained to do clinical work with families will find that today's healthcare environment increasingly requires that they be good consumers of research, as well as an increasing need for them to participate in studies of the models we wish to preserve. At a recent NIMH-sponsored conference, a speaker lamented the probable demise of some of our more interesting family approaches because third-party payers tend to support only evidence-based interventions. Clearly, we need to be able to defend our practices, and understanding the value and essential components of scientific methodology and research studies is likely to become even more important in the future. This new series will attempt to provide an orientation for those of our readers who are interested. We welcome your response to these articles and your suggestions for future segments.

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