Landes, Judah & William Winter (1966): A New Strategy for Treating Disintegrating Families. In: Family Process, 5 (1), S. 1–20.
Abstract: A radical innovation IN family therapy will be described in detail in this paper. This treatment technique extends current methods of family therapy (1) and differs considerably from the traditional techniques of dynamic psychotherapy, particularly in the handling of the patient-therapist relationship.
The program of communal therapy to be described involves three unique therapeutic procedures: (a) The patient families spend a 48-hour weekend together in a communal living experience. They receive intensive, continuous, formal and informal psychotherapy from all the other participants, both staff and patient families, involved in the weekend. (b) The therapists and their families live with the patient families and participate with them in all therapy and social activities. (c) There is a constant effort by therapists and staff to focus the patient families on social reality; specifically, this is accomplished by denoting false or fantasy solutions, unreal problems, and avoided problems that the patient families are presently experiencing.
The families that have been invited to the family therapy weekend are those who appear to be in the process of familial disintegration. These are families with little or no internal cohesion, whose communication process and ability to trust each other are severely impaired. They frequently resort to individual, nonadaptive, acting-out solutions to family problems, and often appear as bizarre but not frankly schizophrenic. These families make little or no progress in office therapy on a once-a-week basis, and they present themselves as families without hope. There is no reason, however, to feel this is the only kind of patient family that can benefit from the procedures described here.
Since communal therapy was started with families of boys living at the Shady Grove Boys Ranch, it is necessary, in order to understand the present procedures, to provide a synopsis of the therapeutic programs as they evolved at this residential institution. This history of therapeutic strategies is not unique, but the communal approach to family treatment, the outcome of this history, is new and different. Besides, the therapeutic mistakes and false starts are in themselves instructive.
Schreiber, Leona E. (1966): Evaluation of Family Group Treatment in a Family Agency. In: Family Process, 5 (1), S. 21–29.
Abstract: The family service agency of the Assistance League, during its many years of working with behavior problems of children and adolescents, early found that such symptoms were usually correlated with families in which there were other indications of unhappiness and disorganization, and that problems created by marital and parental discord, sibling rivalry, and other intrafamilial difficulties were interactive and contagious. Treating only one aspect of such cases, usually the problem behavior, was often unproductive and the gains temporarily sustained. Thus the importance of basic family orientation in the treatment of disturbed children was recognized, and the Agency expended much thought and effort over the years in individual, collaborative and conjoint work with parents and children, again with variable results. A group therapy program initiated in 1957 indicated the value of working with interactional processes, as well as the greater ease with which certain types of clients could accept and utilize group rather than individual treatment methods.
In 1960, the Agency became interested in family group therapy as developed by the Palo Alto Mental Research Institute, Dr. Nathan Ackerman, Dr. Murray Bowen, John Bell and others. Its basic thesis that the family itself is the unit of diagnosis and treatment and that behavior and emotional problems of its members are symptomatic of dysfunction in family interactional processes offered a promising new vista for treatment. The Agency wanted to test these concepts and methods with its own client group to find out whether they were potentially more effective and time-saving in the resolution of interactional family problems, particularly those in which a child or adolescent was presenting serious behavior disorders. It was also interested in learning whether treatment of the dysfunctioning family unit itself would strengthen the family’s basic structure and thereby sustain treatment gains which would enable both the family and its members to function independently thereafter with personal and social satisfaction commensurate with maximum capacity for maturation.
Ryder, Robert G. & D. Wells Goodrich (1966): Married Couples’ Responses to Disagreement. In: Family Process, 5 (1), S. 30–42.
Abstract: Marriage research seems to have emphasized a two dimensional view of married life. The literature reviewed by Tharp (14) seems largely to differentiate marriages in terms of satisfaction (or adequacy, or solidarity). There are “good” marriages (husbands and wives report themselves satisfied) and “bad” marriages (spouses get divorced, or at least report themselves dissatisfied) and points between. The second popular mode of differentiation concerns power, with marriages varying from autocratic to syncratic, for instance, Herbst (7); or in terms of husband versus wife power, for example, Heer (5, 6), Blood (2), Hoffman (8). The present research is an attempt toward constructing a somewhat fuller dimensional framework, with the restriction that dimensions should be well measured. One notable earlier effort is Tharp’s (15) factor analysis of Kelly’s (10) data. Whereas Tharp considered reported role enactments and expectations, the present analysis is based on observations of the different ways couples discuss, argue, fight or otherwise respond to differences of opinion.
These particular differences of opinion were generated by Goodrich and Boomer’s (4) Color Matching Test (CMT). Unlike Strodtbeck’s revealed differences technique (12, 13) which exploits previously existing disagreements, the CMT, along with the similar Stereognosis Test of Flint and Ryder (3), generates new disagreements by using deception, and therefore achieves close control over the disagreements’ content and past history. The price paid for content control is that couples discuss mattersnamely distinctions among patches of colored paperthat are somewhat removed from their customary concerns.
Ryder, Robert G. (1966): Two Replications of Color Matching Factors. In: Family Process, 5 (1), S. 43–48.
Abstract: This presentation offers a comparison of two replication samples with Ryder and Goodrich’s factor analysis of 17 variables from the Color Matching Test of Goodrich and Boomer (1). Information on the dimensional stability of the Color Matching Test is provided which is also pertinent to the expectable stability in general of factor analysis of such relatively small samples.
Miller, Daniel R. & Jack C. Westman (1966): Family Teamwork and Psychotherapy. In: Family Process, 5 (1), S. 49–59.
Abstract: In clinical work as in mining the prospector who has located a rich vein devotes his initial efforts to describing the properties of the find. An increasing number of investigators, for example, have been exploring the connections between certain symptoms and mutual activities in the patients’ families. Abundant evidence has been cited to show that families “need” to have the patients retain such pathologies as phobias, schizophrenic symptoms, character traits, and some forms of retarded reading, the topic of this paper.
Unlike the miner, who employs the terminology of the minerologist and the instruments developed by the engineer, the clinician lacks shared concepts and standardized instruments for exploiting his new find. Hence, although clinical accounts permit the reader to visualize with ease how the patients’ problems help relatives to maintain their relationships and how families work together to resist change, there is little consensus about terms or even about the questions that are being asked. Various writers assert that they are concerned with such diverse issues as role interaction, internal dynamics, barriers to communication, collusion, compatibility, the distribution of power, and conflict between role and identity. If a researcher’s findings are inherent in his questions, as many philosophers maintain, he can have little basis for organizing his efforts or interpreting the results until he is clear about his definitions and his original questions.
The object of this paper is to outline some of the primary questions and explanations about etiology and treatment that we have been developing in a study of functional retardation in reading (2). The subjects are white boys, between the ages of eleven and fifteen years, retarded at least two years in reading level, but without evidence of neurological or uncorrectable visual pathology, and at least normal in I.Q. on a nonverbal test. These subjects are outpatients at the Children’s Psychiatric Hospital of the University of Michigan.
Even in our preliminary observations of retarded reading we were struck by two types of cases. In one the functionally retarded reading can be explained by poor teaching or traumatic experiences but not by familial patterns. In the other the difficulty seems to buttress relationships among family members, who have an investment in perpetuating the symptom, and, indeed, engage in activities that reinforce it. Boys in the former category, unlike those in the latter, profit from remedial teaching.
In what follows we first summarize some of the highlights of our earlier observations and some of our major concepts. We then use them to explain the roots of the symptom, its contributions to the stability of different kinds of family relationships, its maintenance by the family’s teamwork, and its resistance to psychotherapy.
Ferreira, Antonio J., William D. Winter & Edward J. Poindexter (1966): Some Interactional Variables In Normal and Abnormal Families. In: Family Process, 5 (1), S. 60–75.
Abstract: Basic to any investigation of the family group is the assumption that the distinction between “normal” and “abnormal” must be reflected in variables which can be measured in the family interaction (2). These differences may, of course, be qualitative as well as quantitative, and their elucidation is likely to keep researchers occupied for many years to come. However, to make a start, parsimony dictates that we first inquire into those variables which are most obviously related to immediate theoretical questions and most easily measured by the currently available research tools. Thus, this investigation was undertaken with the purpose of searching for answers to some rather simple first questions about family interaction: In a “normal” family, who talks the most? Who talks the least? How much do verbal statements overlap? How much time does a family remain silent while performing a task that calls for exchange of information among family members? How much, and in what way, do “abnormal” families differ from “normal” families in these respects, if at all? And, if these differences exist, are they specific to some particular “abnormal” subgroup, to some diagnostic category?
Brody, Elaine M. & Geraldine M. Spark (1966): Institutionalization of the Aged: A Family Crisis. In: Family Process, 5 (1), S. 76–90.
Abstract: In the past several decades, the population explosion of aged citizenry has focused attention on the crises of aging. During the same time span, there have occurred demographic, social, and economic changes such as urbanization and industrialization which have weakened the three-generation family “as a household and as a unit of production” (2). The convergence of these developments has been reflected by an upsurge of applications for institutional placement of aged persons. Responsible and concerned professionals are engaged in a continuing process of evaluating institutionalization as a solution and in seeking, considering, and exploring other alternatives.
“Throughout human history, the family has been the safest haven for the aged. Its ties have been the most intimate and long-lasting, and on them the aged have relied for greatest security” (1). Modern “Homes” for the aged have evolved from the concept of existing as a last refuge for the homeless and economically deprived aged person without family ties. Currently an overwhelming majority of applicants do have families,1 and their applications have a variety of social, psychological, and medical motivations. The more sophisticated institutions, particularly in large urban areas, have recognized and implemented the need for professional social work as one of a wide spectrum of services for those under care, and as the core discipline in the management of the “Intake” or screening process.
In contemporary progressive “Homes,” as in mental hospitals, the philosophy of “custodial care” is rapidly being replaced by a dynamic treatment- and service-oriented approach. The professional community is sensitive to and appreciative of the deep mutual significance of the inter-relationships between the aged person and his family members. The full effect on the total family of its problem with an older family member is often revealed during the contacts which flow from the initial request for institutionalization. The impact, felt even unto the fourth generation, has been described as the “inter-generational component” (3). The number of people affected is thus enormously increased; the problem is thereby compounded and complicated.
Experience has demonstrated the need for the family to be involved in the planning or the placement process or both. Because of the significance for each family member, such involvement cannot be viewed solely as a means of supporting or preventing sabotage of the plan of choice for the aged person. With this viewpoint as the frame of reference, this paper undertakes to examine the request for institutionalization in terms of its familial implications. Illustrative case material will be presented and discussed.
Arlen, Monroe S. (1966): Conjoint Therapy and the Corrective Emotional Experience. In: Family Process, 5 (1), S. 91–104.
Abstract: The central idea of this report will be focused around the concept of the “corrective emotional experience” which was described over a decade ago by Franz Alexander (1). He felt it was an essential element of any psychotherapeutic endeavor and described it in one paper as follows:
The essence of the therapeutic process consists of the difference between the physician’s reaction and that of the parents, parent substitutes and/or siblings….Equally important, however, is the recognition on the patient’s part that these reactions are not suited to the analyst’s reactions, not only because he is objective but also because he is what he is, a person in his own right….The patient is no longer a child, and the persons with whom he has to do are not parental or fraternal figures. This recognition is not merely intellectual insight, but is at the same time an emotional experience….The recognizing and experiencing this discrepancy …is what I call the corrective emotional experience.
The assumptions implied in the above as well as those necessary for the discussion that follows are listed briefly below:
1. Each person is the product of his past experiences as well as his constitutional make-up.
2. A neurotically disturbed person functions in a relatively stereotyped maladaptive pattern with respect to reality.
3. This maladaptive pattern was learned during early stages of his development in relation to parents or other significant
persons and has not been sufficiently modified during the “growing up” process to fit appropriately and flexibly into the current scene.
4. Any effort to modify these behavior patterns usually creates intense feelings of anxiety, hostility and insecurity within the patient.
5. The patient’s maladaptive behavior patterns operate subtly and repetitiously in ways that tend to evoke expected reactions of rejection, hostility and resentment in the significant people around him. This vicious cycle or “error activated system” tends to sustain both the interpersonal and intrapsychic disturbance.
Levin, Gilbert (1966): Communicator-Communicant Approach to Family Interaction Research. In: Family Process, 5 (1), S. 105–116.
Abstract: A major obstacle in family interaction research has been the complexity of the phenomena being studied. When two or more people are interacting freely, the things that go on are so numerous, so complicated, and so tightly interconnected that it is nearly impossible for the human observer, together with the currently available extensions of his perceptual apparatus, to untangle what has happened in a minimally inferential way. The purpose of this paper is to introduce a method suitable for the study of interpersonal processes in the family. Results obtained in an exploratory experiment on the etiology of schizophrenia will be used to demonstrate the promise of the method.
Jackson, Don D. (1966): Family Affairs. In: Family Process, 5 (1), S. 117–118.
Abstracts of Literature. (1966): In: Family Process, 5 (1), S. 119–122.
Glick, Ira D. (1966): Review – The Family and Human Adaptation, Theodore Lidz, M.D., New York, International University Press, 1963. In: Family Process, 5 (1), S. 123–123.
Kursh, Charlotte (1966): Review – The Family and Social Change: A Study of Family and Kinship in a South Wales Town, Colin Rosser and Christopher Harris, New York, The Humanities Press, 1965. In: Family Process, 5 (1), S. 123–125.
McReynolds, Paul (1966): Review – The Promised Seed, Irving D. Harris, New York, The Free Press, 1964. In: Family Process, 5 (1), S. 125–126.
Curry, Andrew E. (1966): The Family Therapy Situation Therapy Situation as a System. In: Family Process, 5 (2), S. 131–141.
Abstract: In supervision of and consultation to family therapists, there is a consistent linguistic peculiarity used when the therapist discusses the caseparticularly problem areas of the case. Frequently used are such phrases as: “I feel they’re trying to get us to …,” “… they’ve maneuvered me into …,” “… It’s like getting sucked into their way of talking …” “Their communication patterns are so seductive I get caught up in it myself …”. The implication in these comments is that there is a powerful matrix of forces operating in the family unit and that the therapist cannot, without great caution and skill, avoid being literally caught up in the processes of the family unit.
This paper will attempt to describe processes which occur between a family unit and the family therapist. It can be said that these processes are “initiated” by the family to disrupt the overall family therapy situation, to neutralize the effectiveness of the therapist, and to re-establish and maintain the family’s pretherapy equilibrium.
Meissner, W. W. (1966): Family Dynamics and Psychosomatic Processes. In: Family Process, 5 (2), S. 142–161.
Abstract: The effects of psychological factors in the precipitation and etiology of disease have been given increasing attention in recent years. Certain lines of research have established beyond reasonable doubt that psychological factors do play a considerable role in the occurrence of certain types of physical malfunctioning. Thus the case for the operation of stress factors in the production of gastric ulcers (34) has been well established, even though our concepts regarding the manner in which stress factors affect the local functioning of the gastric mucosa are not as precise as one might wish. Along another dimension of the problem, it is more or less generally agreed that certain types of personality organization are more susceptible to the influence of such factors and tend to react to stress or conflict by some form of somatic dysfunction. But here again we lack clear ideas of what specific types of personality organization demonstrate such susceptibility and also what aspects of personality organization are critical in the occurrence of physical dysfunction.
Intensive study has been done to illuminate the relations between the occurrence of various patterns of physical illness and the incidence of emotional traumata of one kind or another. The hypothesis underlying this interest has postulated that the connecting link is stress, specifically that the emotional disruption associated with traumatic events causes a disorganization of autonomic and hormonal regulatory systems, possibly mediated by the limbic system (38) which is responsible for organic dysfunction and ultimately pathology. On another level, attempts have been made to specify the constellations of personality factors which relate to the incidence of certain kinds of illness. Here attention has been drawn to the frequency of maladaptive patterns of personality organization, but success in establishing an association between specific personality types or patterns of dysfunction with patterns of illness has been limited.
In the past few years, considerable amounts of evidence have come to light which point to the implication of dynamic factors of the family process in the psychogenesis of maladaptive emotional behavior (40). In the course of the study of such psychodynamics within families, the impression of the impact of dynamic patterns of family interaction, not only on the psychological adjustment of its members, but also on the patterns of physical health and illness, has been striking. It is our own intention here to review the established associations of emotional dysfunction and physical illness and to propose some tentative relations to dynamic factors operating in the family.
Zuk, Gerald H. (1966): The Go-Between Process in Family Therapy. In: Family Process, 5 (2), S. 162–178.
Abstract: A Discussion dealing with the concept and exercise of power in human relationships demands a definition of power at the onset. The working definition in this paper is the capacity of a person to define, characterize or otherwise control relationships with others and at the same time to initiate actions leading to a predicted increase in control. The concept of therapeutic power will mean the capacity of the therapist to define the therapist-patient relationship and to initiate actions to increase control of the relationship in ways he believes to be in the best interests of the patient.
What are the sources of therapeutic power in family therapy? Most studies touching on this question have followed the psychoanalytic view that insight and the process of making conscious what was unconscious are the key sources. The predominating influence of psychoanalytic concepts in family therapy is reported in recent reviews by Zuk and Rubinstein (6); and Meissner (3). The theme of this paper,mas already stated in a preliminary paper (5), is that a major source having little or nothing to do with insight or awareness per se is the control of what may be called go-between process, a phenomenon of social systems arising particularly in the aftermath of conflict.
Charny, Israel W. (1966): Integrated Individual and Family Psychotherapy. In: Family Process, 5 (2), S. 179–198.
Abstract: This paper advances the concept of a psychotherapy where individual and family interviews are utilized concurrently in a flexible, unfolding sequence that grows out of the flow or movement of each particular case.
By concurrent individual and family interviews we mean most of all that patients experience both types of interviews as parts of a single treatment process, not as combinations of different “therapies.” However, no set allocation of the number of respective interviews is proposed, nor a prescribed sequence of individual and family meetings; just how therapy will be initiated, how frequently one type of interview will be used relative to the other, who is to be seen individually, what shifts will be made as treatment unfolds, all are choices specific to the process of each case and not to be defined in any standardized way.
Cheek, Frances E. (1966): Family Socialization Techniques and Deviant Behavior. In: Family Process, 5 (2), S. 199–217.
Abstract: The significance of parent-child relationships for the later development of a way of life deviant from that normally expected by society has been hypothesized for many years. The emphasis of the psychoanalytic school upon the importance of early familial experience led to the development of such theories in the area of psychopathology, the classic instance being the concept of the “schizophrenogenic mother,” first described by Frieda Fromm-Reichmann in 1948 (14), whose coldness and rejection of her child were said to set in motion a fatal emotional and behavioral withdrawal culminating in the psychotic break. About the same time in 1944, Dr. John Bowlby was the first to suggest “maternal deprivation” as a strong factor in producing serious and persistent delinquency (5). Investigations of these matters in the areas of psychopathology and delinquency proliferated in the years that followed (21).
The fields of social work, sociology, child guidance, and psychoanalysis have contributed to these studies, which have been essentially of two types: one, those which attempted to isolate some aspect of the parents’ personality, believed to be the significant pathogenic element in the parent-child relationship, the so-called “trait” studies (21), and two, those which looked upon the total family unit as disturbed and attempted to describe pathological patterns of interaction within the group (1, 3, 4, 16).
A variety of methods have been used including: case history material, psychological tests, psychotherapy, interviewing, attitude scales and questionnaires, and observational methods. However, highly contradictory findings have emerged and reviewers of the literature (17, 20, 21) in the area have uniformly found marked methodological deficiencies, such as inadequate or nonexistent control groups, inadequate specification of variables, such as socioeconomic status or ethnicity, the use of unreliable and inappropriate instruments, and the very significant and difficult problem of experimenter bias.
In the past few years increased methodological sophistication with regard to these matters has begun to produce studies in which such defects have been attacked and variously minimized. This has permitted a commendable advance in the field; however, another and equally formidable problem remains, namely that of adequate theoretical formulations with which to analyze the relationship between deviant outcome and family process. While many have tried to grapple with this problem, from Freud through the transactionists, it is questionable whether a systematic, experimentally testable theoretical framework capable of investigating the genesis, maintenance or diminution of deviant behavior within the family has yet been produced.
The present paper describes the results of an exploratory testing of one such theoretical framework, that of Talcott Parsons (18, 19) in terms of three types of deviantsalcoholics, reformatory inmates, and schizophrenics. However, the study and its findings are presented, not so much as a confirmation of Parsons’ theories, though they do indeed support his hypotheses, but rather to suggest a line of investigation which with further and more intensive work may prove useful in our understanding of the familial context of deviant behavior.
Kantor, Robert E. & Lynn Hoffman (1966): Brechtian Theater as a Model for Conjoint Family Therapy. In: Family Process, 5 (2), S. 218–229.
Abstract: The usual models for individual psychotherapy are not useful for the evolving conjoint therapies, for the latter are based on the assumption that behavior does not start with the individual but is a matter of shared social activity in which the things people say or do may shape everyone involved. Conjoint family therapy emphasizes the ways in which complex structures of human conduct grow, proliferate, and alter; a new model, therefore, is needed to portray the interplay, the dove-tailing, and the mutual transactions of family members in therapy together. The theater offers an approach to such a model, inasmuch as the structuring and staging of plays suggestively parallels the working operation of family therapy.
Bauman, Gerald & Melvin Roman (1966): Interaction Testing in the Study of Marital Dominance. In: Family Process, 5 (2), S. 230–242.
Abstract: In 1960 we described the clinical use of a technique called Interaction Testing (3). Working with families and small groups ranging from two to 8 members, we first administered to each member of the group a standard clinical psychological test, such as the Wechsler-Bellevue, Rorschach, and TAT. The group or family was then assembled, and the test re-administered to them as a group, with instructions to arrive at responses that were acceptable to the group or family.1 As a result, we were presented with essentially four sources of data:
1. Each individual’s test protocols, administered and scored in the standard manner.
2. One family test protocol representing a group effort, which could be scored in the standard manner (or with minor modifications).
3. The opportunity to compare family responses with individual responses allowing for evaluation of such qualities as the family’s success in optimally using its resources, i.e., the previously demonstrated abilities or responses of the individual members.
4. The interaction processes by which decisions were reached. These could be observed and/or recorded, and could yield suggestive insights, either impressionistically or through more formal scoring and coding procedures.
Our initial experiences with this approach suggested that it held promise for the study of clinically relevant aspects of marital and family functioning, and might ultimately contribute to the development of a clinical taxonomy for families and small groups.
Toward this end, it became necessary to develop standardized procedures, apply them to sizeable samples and thus begin a systematic investigation of the psychometric as well as the clinical properties of Interaction Testing.
Safer, Daniel J. (1966): Family Therapy for Children with Behavior Disorders. In: Family Process, 5 (2), S. 243–255.
Abstract: There is a general trend toward the use of directive approaches in family therapy. Ackerman comments that the family therapist functions as “an activator, a challenger, and a re-integrator of family processes” (1), as well as a setter of rules (2), a referee, a controller, and a balance wheel (3). For Jackson (4), the roles of the family therapist include: framing therapy, giving advice, and serving as a traffic cop. Both Bell (5) and Satir (6) are likewise boldly and clearly goal oriented.
Associated with active direction in family treatment is an emphasis on control. Bell states that family group treatment is a method “which depends on the presence and control of the therapist.” (7) “The family therapist orients the family to the limits he will adopt and holds them firmly.” (8) Haley (9), also in a forceful way, states, “The family therapist takes charge by laying down the general rules of the game for the family….”
To be able to direct and control the structure of treatment, the family therapist must give firm support and set a clear example. Ackerman (3) mentions that the therapist “partly permits himself to be drawn into the center of the disturbance…. The family makes use of him in an effort to do something about their conflicts and fears.” Haley similarly states that the members “observe and utilize for themselves the ways the therapist handles provocations.” (9) “In so doing, the therapist provides the family a model … for handling disciplinary problems.” (10)
The techniques of control, direction, close involvement, and exampleso prominent in family therapyhave also been used for many years in the treatment of character disorders. Aikhorn (11) structured the milieu to suit his purposes, manipulated in therapy, and liberally used the power of his personality to encourage a positive transference. Redl (12), Reiner and Kaufman (13), and numerous other authors (14, 15, 16, 17, 18) stress these therapy methods for their patients with character disorders.
Additionally, in both the treatment of character disorders and in family therapy, the patient’s manipulations have to be limited and the consequences of his behavior brought to the fore. Also, in both, treatment stress is on behavior, the present, the positive and on identification with the therapist.
Therefore, it is quite natural that the family treatment for children with behavior disorders should take a directive bent, with the therapist controlling the structure of the sessions and channeling much of the emphasis.
Watzlawick, Paul (1966): A Structured Family Interview. In: Family Process, 5 (2), S. 256–271.
Abstract: One of the basic assumptions of psychotherapy is that human behavior is not a random phenomenon, but that it is patterned. “Scanning for patterns”is the starting point of all psychotherapy, as it is of all scientific investigation. This paper is a report on an interview technique which reveals family patterns and reduces interview time in family therapy.1
Family oriented clinicians have long appreciated that a) the kind of information needed for their work is largely outside the family’s awareness (thus, direct questioning in order to elicit this information would in most cases be as ineffectual as asking an anxiety neurotic why he is anxious and expecting more than a rationalization or a cliché for an answer); b) in the course of prolonged interviewing repetitive interactions occur which reveal a family’s typical ways of handling stress; c) these are the situations which are considered significant, and their significance lies not only in the content of the communication, but mainly in the specific process of communicating; d) it is obvious that rather than to wait for such situations to occur spontaneously, it is possible to create them deliberately.
Based on these considerations an interview technique was developed and tested over a wide range of diagnostic and behavioral categories. THe number and the nature of the different parts composing the final form of this interview were established empirically; no claim is made that these are the only possible ones or that the interview could not be improved by the introduction of other test situations.
It should also be noted that this interview was not designed primarily as a research tool for measurement of family interaction and, by implication, for comparison between families.2 Rather, the interview was designed as a clinical tool. Its usefulness lies in the fact that its results are evident and directly accessible through observation or even through listening to its tape recording. In fact, this makes it possible for the therapist, having observed the interview through the one-way vision screen, to take a family over for treatment directly from the interviewer at the end of the Structured Interview and to establish the first therapeutic contact already with an understanding of the family’s dynamics and patterns of interaction. No time-consuming transcripts of the tape or complicated scoring procedures are necessary for the use of the Structured Interview as a clinical tool. It is the consensus of those using this technique that it greatly shortens the time required for the identification of typical patterns of interaction, i.e., less than one hour as compared to anything from 5 to 10 hours of conventional interviewing. Its simplicity and brevity and the overt significance of its results appear to be the main reason for the acceptance of the Structured Interview by family oriented clinicians.