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| systemagazin Zeitschriftenarchiv: Journal of Family Therapy Heft 4/2003 |
| 1/2003 - 2/2003 - 3/2003 - 4/2003 - Übersicht Lask, Judith & Arlene Vetere (2003): Editorial. In: Journal of Family Therapy 25(4), S. 315-316 Gupta, Maya, James C. Coyne & Steven R.H. Beach (2003): Couples treatment for major depression: critique of the literature and suggestions for some different directions. In: Journal of Family Therapy 25(4), S. 317-346 abstract: Current couples approaches to the treatment of depression show considerable promise for some couples, but have substantial room for improvement - in terms of efficacy as well as applicability and acceptability to a broader population. Although conjoint approaches have been shown to be efficacious in reducing couple distress and are possibly efficacious in ameliorating depression that co-occurs with couple distress, methodological problems hamper generalization from the published findings. Therefore, it is not clear that most depressed persons are likely to benefit from currently available conjoint formats. Most basically, there may often be obstacles that prevent or delay partner involvement, highlighting the need for treatments that can enhance relationship functioning without relying on a conjoint format. Existing treatment delivery systems may also fail to reach a considerable segment of the population. Developing a more flexible set of options for implementing couple-focused treatment, as well as rethinking dominant assumptions about depression, may be integral to extending the viability of couples therapy for depression. Jones, Elsa (2003): Reflections under the lens: observations of a systemic therapist on the experience of participation and scrutiny in a research project. In: Journal of Family Therapy 25(4), S. 347-356 abstract: The London Depression Intervention Trial (LDIT) was set up in the early 1990s by Professor Julian Leff (Leff et al., 2000, and in this issue) to compare the relative efficacy and costs, in work with depressed adults, of systemic couple therapy, drug treatment and individual cognitive behaviour therapy (CBT). The research found that systemic therapy compared favourably with the other modalities in respect of fewer drop-outs, improvement in measured depression at the end of therapy and on follow-up after a second year without therapy, and was not - contrary to the usual assumptions - more expensive. I was one of the two therapists, together with Eia Asen (Jones and Asen, 2000, and Asen in this issue) practising systemic therapy with diagnosed depressed patients and their partners. In this paper I will discuss the experience of being the object of research scrutiny, and the reflections that have come to me during and subsequent to the research period. To put it more challengingly: What are the consequences for systemic psychotherapists of co-operation with researchers? Can a circular epistemology survive being scrutinized through a lineal grid? Leff, Julian, Barbara Alexander, Eia Asen, Chris R. Brewin, David Dayson, Simon Vearnals & Geoffrey Wolff (2003): Modes of action of family interventions in depression and schizophrenia: the same or different? In: Journal of Family Therapy 25(4), S. 357-370 abstract: The role of relatives' expressed emotion (EE) in mediating the efficacy of family interventions has been studied in randomized controlled trials (RCTs) involving people with schizophrenia and depression. Reanalysis of two RCTs (n=48) by Leff (1989) indicated that lowering relatives' EE and/or reducing social contact between the patient and family members accounted for the efficacy of the intervention for schizophrenia. However, this relationship has not been investigated previously with regard to depression, and this paper presents the results of a recent RCT which included measurement of EE and other possible mediating variables. In this study, amelioration of the critical attitude of the partner did not account for the superiority of couples therapy over antidepressant medication, since the same change occurred in the drug group. However, reducing the patient's exposure to the partner's hostility partially explained the efficacy of couples therapy. Further research on the process of change in families undergoing therapy is indicated to identify the variables that account for the efficacy of therapy. Jaes Falicov, Celia (2003): Culture, society and gender in depression. In: Journal of Family Therapy 25(4), S. 371-387 abstract: The dilemmas inherent in the inclusion of the sociocultural variables in the assessment and treatment of depression are multifold. In this article, three broad themes are selected for discussion: (1) the challenge of cultural translation of mainstream professional definitions of depression to culturally diverse groups; (2) sociopolitical discourses and power differentials regarding gender, class and race and their possible contributions to depression; and (3) the impact of migration, cultural change and generational conflict on manifestations of depression. Ussher, Jane M. (2003): The ongoing silencing of women in families: an analysis and rethinking of premenstrual syndrome and therapy. In: Journal of Family Therapy 25(4), S. 388-405 abstract: Traditionally, explanations for premenstrual symptomatology have focused on the individual woman as the site of difficulties, and as the sole target of intervention. In contrast, from the perspective of a material-discursive-intrapsychic model, this paper will focus on the ways in which 'PMS' is experienced, constructed and dealt with in family relationships. Drawing on in-depth narrative interviews conducted with women with moderate to severe premenstrual symptoms, it is argued that 'PMS' is closely tied to relationship difficulties and responsibilities; familial expectations and attributions for women's behaviour provide a discursive context for behaviour and emotions to be positioned as 'PMS'; and that the ongoing self-silencing and pathologization of women's emotions in families are key attributes of 'PMS'. This suggests that a consideration of relationship issues should be central to any assessment or intervention for premenstrual symptoms, and conversely, that attention should be given to premenstrual exacerbation of relationship difficulties in family or couples therapy. Cottrell, David (2003): Outcome studies of family therapy in child and adolescent depression. In: Journal of Family Therapy 25(4), S. 406-416 abstract: There is surprisingly little good-quality evidence for the effectiveness of family systemic interventions with child and adolescent depression given the prevalence of depression and the demonstrated association with a range of family factors. What studies there are suggest the possibility of family therapy being an effective intervention but more research is needed before firm conclusions may be drawn. Family interventions may be more effective in children than in adolescents and where other family members are depressed. It is possible that family interventions continue to bring about improvement in symptoms after cessation of treatment. What research there is evaluates older structural models of therapy: there is a real need for more evaluation of newer models of practice. Campbell, David, Vicki Bianco, Emilia Dowling, Henia Goldberg, Sue McNab & David Pentecost (2003): Family therapy for childhood depression: researching significant moments. In: Journal of Family Therapy 25(4), S. 417-435 abstract: This paper is a qualitative family therapy process study which is part of a larger European-based outcome study comparing family therapy to child psychotherapy plus parent support for depressed children and their families. The family therapists and two clinical supervisors from the original study formed themselves into a research team to study the process of therapy with twelve families. Therapists selected the significant moments from fifty-nine sessions, and were then interviewed by the research team using a standard protocol to investigate the therapists' own thinking about the significant moments. Applying a thematic analysis, the significant moments were clustered into eleven themes. The paper discusses the rationale for this model of research, which is well suited for clinical teams, and the application of the themes to therapeutic work with depressed children and their families. Eisler, Ivan (2003): Why talking (and listening) is better than trying to build bridges. In: Journal of Family Therapy 25(4), S. 436-442 Rivett, Mark (2003): The family therapy journals in 2002: a thematic review. In: Journal of Family Therapy 25(4), S. 443-454 abstract: This article reviews the principal English-language (including British) family therapy journals for the year 2002. A number of common themes and threads predominate within these journals. Articles relating to these themes are reported under distinct headings. These themes were: responding to 9/11; marital therapy and diversity practice. Significant research papers are incorporated into the relevant heading. This is the final thematic review undertaken by the current author. |
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