Culture and meaning: expanding the metaphorical repertoire of family therapy

Adaptation as Meaning Construction: A Cultural Analysis of Spousal Death in Taiwanese Women

Using 35 Taiwanese widows as examples, the author argues that interpretations of adaptation to spousal death must be made within a cultural context. The process of adaptation associated with spousal death is analyzed in light of data collected from personal interviews, support group discussions, diary entries, and self-narratives. Results indicate that Taiwanese widows incorporate several dynamic processes into their meaning constructions and gradual modification of personal selves. These include questioning, reconstructing the past, comparison, adopting new meaning, and getting used to it. The authors describe how adaptation for Taiwanese widows differs significantly from Western models.

How couples manage interracial and intercultural differences: implications for clinical practice

This study focused on how couples managed their interracial and intercultural differences. To understand their experiences, a qualitative grounded theory analysis was used (n=17). Analysis revealed that couples experienced most issues as cultural issues; race only occurred during their interactions with "others." They appeared to organize their responses according to four relationship structures: Integrated, Singularly Assimilated, Coexisting, and Unresolved. Couples in each of these structures managed daily process through four sets of relationship strategies: (a) creating a "we," (b) framing differences, (c) emotional maintenance, and (d) positioning in relationship to familial and societal context. These findings are a step toward a strength-based and research-informed education and clinical interventions for this population. Video Abstract.

Power and parenting assessments: the intersecting levels of culture, race, class and gender

This article uses a case example to highlight some of the complexities of working with minority ethnic families. It addresses the dilemmas that exist for therapists and other professionals when carrying out cross-cultural assessments of parenting. In this article, we will examine how professionals' constructions impacted on the assessment process with regard to family life, culture and mental health. We will draw out implications for clinical practice in this area.

Moving beyond the blame game: toward a discursive approach to negotiating conflict within couple relationships

The concept of discourse is an important tool in negotiating conflict and facilitating conversations within therapy. This article offers a useful framework for negotiating conflict in a couple relationship by highlighting the manner in which individual's expectations are mutually emergent from particular discursive positions. Specific discursive practices and approaches that make more visible the cultural production of conflicts are presented via a case illustration. These practices provide more freedom to couples in relationships to explore conflicts with less totalizing descriptions of the other as blameworthy. In addition, a discursive analysis of conflict invites therapists to be more intentional, reflexive, and socially responsible in their work.

Values in the role of the family therapist: self determination and justice

Recently, there has been renewed interest in the role of values in family therapy. A number of theorists agree that there is an inherent ethical dimension in all forms of therapy, because therapy necessarily involves influencing others in accord with a set of values. In cultures that value self determination, a potential conflict arises between the therapist's inherent moral influence and protecting the client's self determination. This article identifies that dilemma and investigates how different treatment approaches resolve it as they attempt to promote justice in the family.

Constructive hypothesizing, dialogic understanding and the therapist's inner conversation: some ideas about knowing and not knowing in the family therapy session

The primary tasks of the therapist can be described as listening to what the client says and making space for what the client has not yet said. According to Anderson and Goolishian, the therapist should take a not-knowing stance in this dialogic process. The question remains, however, what not-knowing exactly means. In this article, I will explore this question and I will propose the concept of constructive hypothesizing. Constructive hypothesizing is described as a process in which there is a movement back and forth between knowing and not knowing. Of central importance are creative and dialogic understanding, rather than knowledge. Recommendations are made to ensure the constructive and collaborative use of hypotheses in the therapeutic dialogue.

Empowering the aged--a postmodern approach

With the growth of the elderly population, the theme of empowerment and its actual negotiation will emerge as an issue of great importance. The aged are vulnerable in many ways and occupy still relatively limited social roles with restricted access to social goods. They are often undermined in their desire for self-determination. It is suggested that by introducing a postmodern approach in helping this group, the basic principles of social work can be enriched. Empowerment that includes opportunities for growth, mastery, significance, and meaning can be substantially increased. This article outlines the rationale for this approach and discusses the process of collaboration, the therapeutic relationship, and intervention strategies. While this article is limited to the elderly, the appreciation of the postmodern approach has implications for people in need for other populations as well.

Tales full of sound and fury: a cultural approach to family therapeutic work and research in rural Scandinavia

The concept of "culture" figured prominently in the development of family therapy. Recent conceptualizations, however, have tended to focus primarily on the ideational dimensions of culture. While not disputing that meanings and other ideas constitute significant features of group lifeways, this article proposes a return to earlier anthropological framings that incorporate material and ideational dimensions of cultures. To illustrate how his expanded concept may serve as a guide for therapeutic work, the article describes therapy with one family at a clinic in rural Scandinavia. We especially focus on the place of key symbols as historical links between the ideational and material dimensions of cultures. The perspective developed here is one of seeing cultures as sets of interpenetrating actions and ideas shaped by as well as shaping their practitioners.

Family connectedness and women's sexual risk behaviors: implications for the prevention/intervention of STD/HIV infection

The present study explores the relationship between connectedness with the intergenerational family and women's sexual risk-taking as a guide to the development of family-focused prevention and intervention. Cross-sectional interview data from a pilot study were analyzed for correlations between a number of self-reported, risky sexual practices, the range of extended family members with whom the respondent was in contact, and awareness of stories pertaining to intergenerational family history. Structured interviews were administered by female interviewers to 56 women from two contexts: a STD (sexually transmitted disease) Clinic (N = 26), and an inner-city, Hispanic Community Organization (N = 30). Knowledge of stories about grandparents or great-grandparents was a robust predictor of lower sexual risk-taking in the STD Clinic sample. This relationship persisted, but only at the trend level in the Community Organization sample. In both the total sample and the STD subsample, the number of categories of extended family members with whom a respondent was in at least monthly contact was correlated with less sexual risk-taking. Given the fundamental importance of the family system as the primary social unit, these findings argue for further family theory-based research and for its potential application in the development of health prevention and intervention. Implications for practice and future research are discussed.

The importance of cultural sensitivity and therapist self-awareness when working with mandatory clients

Systemic therapy emphasizes the importance of understanding each relationship in the context of its ecosystem. Considerations such as the influence of social agencies, culture, and the therapist's self-awareness are described in the literature as amplifying lenses within the therapeutic relationship. When a minority client is caught in the web of larger system agencies and is mandated to family therapy, systemic family therapy, which incorporates multiple lenses and attends to the context of social background, may provide a better understanding of the client's reality. Clinical cases show that therapists may slip into veiled racist and discriminatory attitudes with minority clients. Self-awareness, "soul searching," and appropriate supervision may be of tremendous help in learning from such experiences. A case example illustrates the application of this approach.

Reflections on ways to create a safe therapeutic culture for children in family therapy

Although a large number of publications in the family therapy field stress the importance of children in family therapy, some authors report that, in practice, many family therapists do not actively involve children in their therapies. In this article, I reflect on the experiential reasons for this exclusion of children. I will consider the importance of the use of the self of the therapist and of the creation of a safe therapeutic culture for the child. Practical suggestions are made of ways to involve children in family therapy. Finally, these ideas are illustrated in a case example of a family therapy with an adoptive family.

The small and the ordinary: the daily practice of a postmodern narrative therapy

In this article, I contrast assumptions of a modernist worldview and a postmodern worldview as they relate to clinical practice. Two exercises are described that help therapists develop insight into and practice with the kind of thinking that is consistent with a postmodern narrative clinical practice. Particular attention is paid to the ways that even the small and the ordinary--single words, single gestures, minor asides, trivial actions--can provide opportunities for generating new meanings. Five concepts that I routinely use in my professional and personal life and that are consistent with a postmodern narrative practice--discourse, externalizing the internalized discourse, exceptions, power as the means to produce a consensus, and characteristics of narrative--are illustrated.

Hearing metaphor: an approach to working with family-generated metaphor

This article presents a step-by-step approach to working with family-generated metaphor in family therapy. Although the use of therapist-generated "therapeutic metaphors" has been widely advocated and practiced for many years now, less attention has been paid to the metaphors used by family members. We argue that the family's metaphors are a neglected linguistic resource in family therapy. Highlighting and validating these metaphors produces a therapeutic conversation in which the voices of family members are heard more clearly by the therapist, and the families' own imaginative energies are engaged in defining and pursuing the goals of therapy. Several case examples illustrate the use of this approach with children of various ages.

The politics of gender in family therapy

This article provides an overview of the political implications of various approaches to gender within the clinical literature. It emphasizes the process of therapy within the social context of gender relations and identifies the political consequences of various clinical responses. Issues surrounding the appropriate role and stance of therapists relative to gender are identified, ethical issues such as neutrality and client welfare are re-examined, and suggestions for practice are addressed.