rhr: Assessment of Diverse Family Systems
rhl:Handbook of Multicultural Assessment
CHAPTER 12: ASSESSMENT OF
DIVERSE FAMILY SYSTEMS
DANIEL T. SCIARRA
GEORGE M. SIMON
case extract begins
Elana stared plaintively for a moment at her husband, Curtis, and then
turned toward the therapist: “We were a happy couple as long as we were
both foreigners. Now that I am the only foreigner and he is on his home
turf, everything has turned sour.”
Curtis and Elana sought couple therapy after she had stumbled on the
fact that he had been having an extramarital affair. This was the third time
that Elana had caught Curtis in an affair. On all three occasions, Curtis had
ended the affair immediately after Elana discovered it.
Curtis, a native of New York City, had met Elana about six years prior to
the crisis that brought them into therapy. They had met in Israel, where
Curtis was on a week’s leave from his military assignment in Kuwait.
Elana, an Ethiopian Jew, had migrated to Israel with her family when she
was a young child. “We caught each other’s eye at a club,” Curtis
laughingly explained to the therapist, “because we were the only black
people in the place.” The couple had spent an intense week together and
had remained in contact with each other when Curtis returned to his
assignment. A few months later, he had been reassigned to a post in
Virginia. He invited Elana to join him, and she accepted. The two got an
apartment together and married within a couple of months.
As they told their story to the therapist, both spouses agreed that the
ensuing two years had been idyllic. This was the period when, in Elana’s
words, they were both “foreigners.” Curtis had found rural Virginia, where
they were living, almost as foreign as had Elana, and so, out of necessity,
the spouses had developed an intense reliance on each other. Except for
when Curtis was working, they became nearly inseparable. Happily, they
found that they enjoyed each other’s company immensely.
1
Then came the development that instigated the rapid unraveling of the
couple’s tightly wound relationship. Curtis was transferred to a recruiting
office not far from the New York City neighborhood where he had grown up
and where most of his family and childhood friends still resided. They
secured an apartment in Curtis’s old neighborhood, and Curtis began
renewing his old social contacts. As Elana astutely observed, she was now
the only “foreigner” in the marriage. Where Curtis had previously thrived on
Elana’s dependence on him, he now began to experience her as “clingy”
and “needy.” He began to put distance between himself and his wife, and
she began to make ever more exaggerated expressions of dependence on
him.
Curtis had his first affair four months after he and Elana moved to New
York. Over the course of the next two and a half years, he had become
involved in two more. Each of the affairs had ended with the same
dramatic scene in which Elana confronted Curtis with the evidence she
had accumulated, and he, penitently admitting to his transgression,
begged her not to end the marriage. The couple’s most recent rendition of
this now all-too-familiar scene had been played out two weeks prior to their
first meeting with the therapist.
It was now the therapist’s task to decide how to intervene into this
troubled marriage.
Family Assessment: A Range of
Options
The literature of the field of family therapy makes available to Curtis
and Elana’s therapist a considerable array of assessment schemes and
related therapeutic protocols that the therapist could use to make sense of
and intervene into the couple’s functioning. So numerous, in fact, are such
schemes and protocols that several efforts have been made to organize and
categorize them.
Minuchin, Lee, and Simon (2006), for example, have divided family
therapy models into interventionist and restrained approaches.
Interventionist models, as they are defined by these authors, prescribe a
relatively high degree of activism on the part of the therapist, aimed at
eliminating family dysfunction. Restrained models seek to protect client
families from a therapist’s potentially disempowering meddling by severely
restricting the domain of family functioning into which the therapist is
2
allowed to intervene or by prescribing an exaggerated posture of tentativity
for the therapist.
In a related effort at categorization, Simon (2003) has attempted to
organize family therapy models based on the models’ underlying stances on
the five fundamental philosophical issues: “the relationship between the
individual and the group, the proper use of human freedom in
relational/ethical decision making, the question of whether humans are
capable of doing evil, the relationship between mind and body, and the
question of whether primacy in the human domain belongs to being or
becoming” (Simon, 2006, p. 334)
Yet another way of categorizing family therapy models can be used
to throw into relief the manner in which the models deal with the issues
raised by a multicultural perspective. Fraenkel (1995) has proposed that
models of family therapy can be categorized as being nomothetic or
idiographic in their orientation. Nomothetic models use concepts of
allegedly universal validity to reach normative judgments regarding the
relative adaptiveness of a given family’s functioning. Idiographic models
eschew universal descriptive schemes in favor of viewing each family as a
unique entity. We find Fraenkel’s proposal helpful and use a modified
version of it to provide an overview of the varying ways in which the major
models of family therapy deal with the issue of multicultural assessment.
Instead of a simple dichotomous characterization of the models as being
either nomothetic or idiographic, we use a tripartite scheme, depicting
models as nomothetic, idiographic, or a systematic blending of nomothetic
and idiographic elements.
Idiographic Models
Paré (1995, 1996) provided perhaps the clearest and most concise
statement of an idiographic perspective on family therapy when he
proposed that family therapists think of each family as a distinct culture
unto itself. Family therapy, Paré (1996) asserts, can be thought of as an
encounter between two cultures: the culture that is the client family and the
culture that is the therapist.
If each family is a culture unto itself, then any attempt to understand
the family using concepts imported from the outside—equivalently, from a
foreign culture—constitutes nothing less than an exercise in colonialism.
Preexisting assessment schemes thus need to be assiduously avoided in
clinical practice:
When informed by the metaphor of a meeting of cultures, I
am inclined in my clinical work to take heed of the
3
practices that have been seen to lead to the devastation of
indigenous cultures. The metaphor itself entails the
hegemonic risks associated with the practice of therapy: the
therapist as colonial power (Kearney, Byrne, and
McCarthy, 1989), the therapeutic model as the dogma of a
foreign culture, the therapy room as the mission school
where religious conversion and cultural assimilation are the
undergirding agendas [Paré, 1996, p. 28].
The postmodern therapies developed by Harlene Anderson (1997,
2001; Anderson and Goolishian, 1988), Steve de Shazer (Berg and de
Shazer, 1993; Miller and de Shazer, 1998, 2000), and Michael White
(1991; White and Epston, 1990) exemplify Paré’s idiographic aversion to
preexisting assessment schemes. Key concepts of these idiographic models
are presented in Table 12.1.
Table 12.1.~NSKey Concepts of Representative Idiographic Models
MODEL
LITERATURE REFERENCES
Collaborative Anderson (1997, 2001);
language
Anderson & Goolishian,
systems
1988)
therapy
Solutionfocused
therapy
Berg & de Shazer
(1993); Miller & de
Shazer (1998, 2000)
Narrative
therapy
White (1991); White &
Epston (1990)
GOAL OF
THERAPY
Facilitate the
ongoing
elaboration of the
constellation of
meanings that
the client family
has developed to
describe and
explain the
presenting
problem
Help the client
family to identify
and amplify
exceptions to the
presenting
problem that are
already occurring
Liberate the client
family from the
subjugating
influence that
societal-level
cultural
discourses have
on the family’s
indigenous
meaning making
and wisdom
4
SIGNATURE INTERVENTION
Questioning based on an
attitude of “not knowing,”
that is, an attitude that no
meaning expressed by
clients is simple, clear, and
easily understandable
Questioning and tasks
designed to help clients
identify and amplify
exceptions to the
presenting problem
Externalization (the
depiction of the family as
beset by an
anthropomorphized
external enemy, bent on
subjugating the family)
Anderson’s collaborative language systems therapy is typical of
these models, when it demands that its practitioner enter into each
therapeutic encounter with a family with an attitude of “not knowing.” The
language systems therapist does not use an assessment protocol to make
sense of the client family’s situation; instead, the therapist listens carefully
to the sense that family members themselves are already making of their
own situation.
A language systems therapist working with Elana and Curtis would
note Elana’s use of the word foreigner and Curtis’s use of the word needy
to make sense of their relational situation. These words would be
significant for the therapist not because they have some relevance to an
assessment scheme that the therapist brought into the therapy, but because
the words are central to the language the clients themselves are using to
assess their own situation.
As conceived in the collaborative language systems approach to
therapy, it is the therapist’s task simply to ask questions that invite family
members to elaborate further the home-grown constellation of meanings
that have evolved within the family to describe and explain the therapy’s
presenting problem. In doing so, the therapist assiduously avoids leading
the therapeutic conversation in any given direction, based on some
preunderstanding of the clinical situation:
The language systems therapist attempts to keep the
[family’s] conversation fluid by adopting the attitude that
no meaning expressed as part of the conversation is simple,
clear, and easily understandable. . . . Participating in the
[family’s] conversation in this way, the language systems
therapist helps keep the conversation tending in the
direction of the not-yet-said [Simon, 2003, p. 22].
The model assumes that given the inherent evanescence of meaning,
a fluid conversation about the presenting problem, tending always toward
the not-yet-said, will inevitably evolve to the point where the presenting
problem is defined out of existence (in the language of the model, dissolved).
While the collaborative language systems approach to therapy
focuses on a client family’s idiosyncratic meaning making around
something that they have defined to be a problem, de Shazer’s[[AU: Add
to the References, and insert the date here. ]] solution-focused therapy
focuses on the family’s idiosyncratic solutions to the problem. As much as
the collaborative language systems therapist does, the solution-focused
therapist avoids imposing any kind of preunderstanding on the clinical
situation. Thus, like a language systems therapist, a solution-focused
5
therapist would refuse to use any kind of preexisting assessment scheme to
inform a therapeutic encounter with Curtis and Elana, choosing instead to
use what is indigenous to the couple. However, different from a language
systems therapist, a solution-focused therapist would be relatively
disinterested in how the couple is making sense of their situation. Instead,
she or he would be interested in unearthing what Elana and Curtis are
already doing from time to time, separately or collectively, to alleviate, at
least a little bit, the state of affairs that they have presented as the problem
to be addressed in therapy.
That Curtis and Elana are already enacting such solutions is an
article of faith for the solution-focused therapist. At the beginning of
therapy, the therapist does not know what they are. True to the
nonnormative ethos that characterizes all of the idiographic models of
family therapy, the solution-focused therapist certainly has no preexisting
notion of what these solutions should be. The therapist restricts himself or
herself to the task of asking Curtis and Elana questions and giving them
tasks designed to help them become aware of what they are already doing
to contain and alleviate their presenting problem. Once the couple has
identified their idiosyncratic solutions to their presenting problem, the
therapist will encourage them to amplify these solutions.
White’s narrative therapy values the indigenous meaning making
and wisdom of families as much as do collaborative language systems
therapy and solution-focused therapy. However, it is far less optimistic than
the other two models that a simple therapeutic conversation, focused
exclusively on the local culture of a client family, can succeed in bringing a
client family’s indigenous wisdom to the fore.
The narrative model is founded on the keen awareness that local
conversations, within a family and within the therapy room, take place
within the context of broader sociocultural discourses. The model views
these broader discourses negatively, seeing them as inevitably working to
subjugate and eradicate local meaning making and wisdom:
Narrative therapy sees group-level phenomena as being
inevitably dehumanizing. For narrative therapy, that which
is authentically human is always found at the level of the
local and the particular. The further one moves from the
level of the individual, the more one moves into the domain
of the impersonal, the coercive, and the dehumanizing
[Simon, 2003, p. 28].
It must be noted that narrative therapy’s negative valuation of
societal-level cultural discourses is not restricted to the discourses of a
given society’s dominant culture. Rather, all cultures, including those that
6
might have minority status within a given society, are seen as ultimately
dehumanizing and coercive. Narrative therapists Griffith and Griffith
(1994) state this view plainly: “Authentic expression of personal experience
is always fluid, idiosyncratic, and unpredictable. It does not know the
bounds imposed by cultural practices. . . . It inevitably takes a stand against
some type of cultural practice (p. 58, emphasis added).
Avoiding preexisting assessment schemes, the strategy used by the
language systems therapist and the solution-focused therapist to avoid
subjugating a client family’s local culture will not, in the view of the
narrative therapist, succeed in purging the therapeutic conversation of the
destructive influence of broader sociocultural discourses. The only way that
the therapeutic conversation can achieve the liberation of a client family’s
local knowledge, the goal of all the idiographic therapies, is for the
conversation to focus explicitly on the pervasive, corrosive effects of
societal-level cultural discourses.
Noting how frequently Elana and Curtis use the word foreigner to
make sense of their relational difficulties, a narrative therapy working with
them would attempt to sensitize them—and to increase her or his own
sensitivity as well—to the negative connotations imparted to this word by
the various sociocultural discourses in which the therapist, Curtis, and
Elana are immersed. The therapist would have used this strategy no matter
what language the couple used to explain their problem. In the view of the
narrative therapist, the problems that lead people to seek therapy are almost
invariably the result of the impoverishing, subjugating influence that
sociocultural discourses have on the language people use to make sense of
their life together.
In order to make their subjugation visible to Curtis and Elana, a
narrative therapist would use the signature narrative technique of
externalization. The therapist would anthropomorphize “foreignness,”
depicting the couple as tyrannized by this external enemy bent on
destroying their marriage. Using an elaborate protocol of therapeutic
questions, the therapist would ask the couple to explore the destructive
influence that foreignness has had on their relationship. Crucially the
therapist would ask Elana and Curtis to detail how they, separately and
collectively, have succeeded in keeping foreignness from damaging their
relationship even more than it has. The narrative therapist would anticipate
that in response to this questioning, the couple would move from the
mutual blaming in which they are currently engaged, a blaming that serves
only to increase the power of foreignness, to a pooling of resources in a
shared battle against the externalized enemy into which the therapeutic
conversation would have transmuted foreignness.
7
In their prizing of local knowledge and their wariness of becoming
mechanisms of cultural domination, the idiographic models of family
therapy are thoroughly in sync with the fundamental ethos of the
multicultural movement in the mental health disciplines. In their zeal to
privilege local conversations and local wisdom, these models have
expunged from the therapeutic protocols that they prescribe the whole
notion of therapist-driven assessment. So thoroughgoing is these models’
wariness of therapy becoming an exercise in cultural colonialism that topics
constituting key components of other multicultural therapeutic
approaches—topics such as ethnicity, immigration, acculturation, and racial
identity—are in these models either completely ignored (unless raised by
the clients themselves) or, in the case of narrative therapy, seen as part of
the problem (therapist-driven, professional discourse) rather than part of the
solution.
Nomothetic Models
Where the idiographic models of family therapy bring client
families’ own assessments of their life situations to the fore of the
therapeutic encounter, the nomothetic models prescribe a therapy process
constructed around therapists’ assessments of what is transpiring in
families. These therapist-driven assessments use preexisting conceptual
schemes that purport to provide descriptions of family processes that
possess near-universal validity.
Before we begin to summarize some of the models that we judge to
be nomothetic in their orientation, we must insert a disclaimer. Our
categorization of models as nomothetic is based solely on the published
literature about these models. We recognize that therapy done can look very
different from therapy written about. It is possible, even likely, that many
practitioners of the models that we are about to mention include, in their
implementation of the models, accommodations to the local and the
particular that are lacking in formal, written renditions of the models. Such
accommodations may or may not fit organically into the model that is being
used. If there is an organic fit, then what is being practiced is not a
nomothetic therapy but a therapy with a systematic blending of nomothetic
and idiographic elements, about which we will have more to say later in
this chapter.
All of what are considered the classic models of family therapy are
unabashedly nomothetic in their conceptualization of the therapeutic
process. All identify some aspect of family functioning that is deemed to
play a determinative role across cultures in the genesis or maintenance of
therapy-relevant human problems. The models prescribe ways in which the
8
therapist can assess this putatively crucial aspect of family functioning. The
models then go on to detail interventive protocols designed to influence this
area of functioning. Key concepts of the nomothetic models that we are
about to summarize, both classic and contemporary, are provided in Table
12.2.
Table 12.2.~NSKey Concepts of Representative Nomothetic Models
MODEL
LITERATURE REFERENCES
Structural
family
therapy
Minuchin (1974);
Minuchin & Fishman
(1981)
Strategic
family
therapy
Haley (1987)
Bowen
family
systems
therapy
Bowen (1966); Kerr &
Bowen (1988)
Emotionally
focused
therapy
Johnson (2002, 2004)
GOAL OF
THERAPY
Adaptively
restructure family
subsystem
boundaries
Adaptively
restructure
incongruous
hierarchies within
the family
Increase family
members’ level of
differentiation
Access and
amplify family
members’
expression of
attachmentrelated emotions
SIGNATURE INTERVENTION
Enactment (direct
interaction between family
members during the
therapy session)
Assignment of betweensession tasks, individually
tailored for each client
family so as to reduce
resistance
Coaching of adult family
members to assume a
more differentiated posture
in their respective families
of origin
Softening, (eliciting the
experience and expression
of soft, attachment-related
emotions)
Structural family therapy is typical of these classic, nomothetic
approaches to family therapy. A structural family therapist working with
Elana and Curtis would enter his or her first encounter with the couple
assuming that their presenting problem is maintained by dysfunctional
boundaries within the relational system of which they are members. Thus,
early in the encounter, the therapist would assess the quality of the
boundary between the spouses and between the spousal subsystem and
other social systems with which it interacts (Minuchin, 1974). (We describe
structural family therapy’s conceptualization of family functioning in
greater detail later in this chapter.)
A practitioner of strategic family therapy would also bring some
well-defined assumptions into this first encounter with Curtis and Elana.
The model that she or he practices is founded on the view that therapyrelevant human problems are maintained by incongruous hierarchies within
family systems (Haley, 1987). These are hierarchies that are either the
reverse of developmentally appropriate hierarchies (for example, a child
9
exercising authority over a caregiver) or a hierarchy that exists where none
is appropriate (for example, between a husband a wife). A strategic
therapist meeting with Elana and Curtis would focus assessment efforts on
detecting the presence of incongruous hierarchies. In the process of doing
so, she or he would almost certainly take note of the fact that most of the
time, Curtis occupies a one-up position in relation to Elana and that this
situation undergoes a temporary reversal and correction of sorts in the
aftermath of Elana’s discovery of an affair.
For a practitioner of Bowen family systems therapy, it is people’s
lack of differentiation that gives rise to symptomatic expression. Lack of
differentiation reveals itself when strong emotions swamp a person’s
cognitive functioning, with the result that the person behaves reactively
rather than in a calm, deliberative manner (Bowen, 1966; Kerr and Bowen,
1988). A Bowenian therapist would see in Elana’s emotional displays of
neediness and in Curtis’s reactive distancing from his wife evidence that
they are both lacking in differentiation. Seeing family-of-origin processes
as exercising determinative influence on people’s level of differentiation,
the Bowenian therapist would mount an effort to assess what
dysfunctionally triangular relational arrangements in Curtis’s and Elana’s
respective families of origin had resulted in the lack of differentiation
displayed in their dealings with each other.
By and large, the classic models of family therapy do not prescribe
the use of formal, structured assessment protocols to elicit the data that they
consider central to the therapeutic enterprise. Practitioners of all three of the
classic models rely heavily on their observation of and interaction with
client families during the first therapy session in order to construct their
assessment of the families. The structural family therapist makes extensive
use of the signature technique of enactment for assessment purposes,
eliciting direct interactions among family members in the consulting room,
which allow the therapist to observe the quality of the boundaries between
family subsystems, and between the family-as-a-whole and the outside
world, represented in the therapeutic situation by the therapist himself or
herself (Minuchin and Fishman, 1981). While perhaps making some use of
enactment, the strategic therapist relies more on questioning to ferret out
the incongruous hierarchies that will become the target of his or her
signature intervention: the assignment of between-session tasks that are
individually tailored for each client family so as to decrease the family’s
inevitable resistance to change. The Bowenian therapist observes clients’
in-session behavior, both toward herself or himself and toward each other,
to detect the presence of the emotional reactivity, which, according to the
model, provides the best indicator of clients’ degree of differentiation.
10
Uniquely among the classic family therapy models, Bowen family
systems therapy prescribes the use of a structured assessment protocol, in
addition to the therapist’s informal observation of family processes
occurring in the therapeutic setting. In order to elicit and organize data
about the family-of-origin processes that the Bowenian therapist considers
so crucial in determining clients’ levels of differentiation, the therapist
engages clients in the shared construction of genograms—diagrams that
graphically display relational processes across at least three generations in
the families of origin of the adult members of the client family. The
Bowenian therapist uses these genograms to guide his or her signature
intervention: the coaching of adult members of the client family to assume
differentiated, nonreactive postures in relating to key members of their
respective families of origin.
Although all of the classic models of family therapy are nomothetic,
so too are many of the models that have been developed more recently.
Typical in this regard is emotionally focused therapy, an evidence-based
treatment for couples presenting relational distress as a focus for treatment
(Johnson, 2004). Grounding itself in attachment theory, emotionally
focused therapy sees most couple dysfunction as resulting from the
intersection of couple members’ maladaptive attachment styles, resulting in
self-reinforcing sequences of destructive interaction. The emotionally
focused therapist seeks to modify these sequences using his or her signature
technique of softening: the empathic accessing and amplifying of “soft,”
attachment-related emotions that are seen as underlying the “hard,” selfprotective emotions that couple members experience and express as they
engage in their usual dysfunctional relational dance.
Accessing these softer emotions requires that the therapist assess the
attachment styles of clients. Although paper-and-pencil instruments are
available for such assessment, the emotionally focused therapist prefers to
rely on direct observation of clients’ behavior toward each other and toward
him or her in the immediacy of the therapeutic encounter in order to
construct an assessment of clients’ attachment styles. Such observation of
Elana and Curtis would likely lead the emotionally focused therapist to
assess that Elana has an anxious attachment style, to which she gives
expression in her pursuit of her husband, and that Curtis has an avoidant
style, which primes his distancing from Elana.
Emotionally focused therapy, like the classic nomothetic family
therapy approaches that came before it, “assumes that we are all children of
the same mother” (Johnson, 2002, p. 54). These models assume that in the
most therapeutically relevant aspects of their functioning, all families are
essentially the same. All the nomothetic models presume that a therapist
11
skilled in assessing families should be able to do so effectively across a
broad range of cultures.
Systematic NomotheticIdiographic Blends
The idiographic models of family therapy are founded on the
premise that all families are fundamentally different; the nomothetic
models assume that all families are fundamentally the same. This difference
in outlook reflects, and has its roots in, a millennia-old quandary within the
Western philosophical tradition regarding how best to conceive the
relationship between the one and the many (see Simon, 2003). Both the
idiographic and the nomothetic models share the strategy of resolving this
quandary by associating themselves exclusively with one pole of this
polarity.
However, another strategy for resolving the quandary is possible.
One can take the position that both the idiographic and the nomothetic
models reflect half, and only half, of the clinically useful truth: in the ways
that matter to the family therapist, families are both all different and all the
same. If one adopts this synthetic position, then what is needed to ground
the therapeutic enterprise are models of treatment that systematically and
coherently blend idiographic and nomothetic elements.
One way of achieving this blend has been proposed by Monica
McGoldrick and her colleagues (McGoldrick, Giordano, and Garcia-Preto,
2005). These authors do not call into question the assumption made by all
nomothetic models of family therapy: that there is some aspect of family
functioning that, across families and across cultures, is pivotally involved in
the genesis or maintenance of therapy-relevant human difficulties.
Accordingly, the authors accept the need for therapists to assess client
families in that area of functioning deemed crucial by the model that they
are practicing. However, the authors demur from the nomothetic
assumption that what constitutes adaptive functioning in this area is the
same across cultures. Different cultures provide differing renditions of
“normal” family life. Thus, McGoldrick would maintain that assessing
boundaries, or hierarchies, or differentiation, or attachment styles in the
case of Elana and Curtis must take into account Elana’s Ethiopian Jewish
cultural heritage and Curtis’s middle-class African American cultural
heritage, which provide the standards against which judgments of
functional and dysfunctional must be made. The work of Boyd-Franklin
12
(2003) and of Falicov (1998) has amplified and extended McGoldrick’s
approach to constructing a systematic blending of nomothetic and
idiographic elements in therapeutic models.
While laudable in their attempt to render family assessment sensitive
to the particularities of culture, the efforts just referenced can be criticized
for overly emphasizing the nomothetic in the systematic nomotheticidiographic blending that they have tried to achieve. Although the efforts
recognize between-culture differences in what constitutes normal family
functioning, they gloss over within-culture differences, and so from an
idiographic perspective, they still tend to privilege the universal over the
local and particular.
George Gushue (1993; Gushue and Sciarra, 1995) has proposed a
scheme of family assessment that he sees as containing, using the language
of this chapter, a more balanced blending of idiographic and nomothetic
elements. Gushue accepts the description of between-culture differences in
normal family functioning offered by scholars like those just referenced.
However, calling on models of cultural-identity development (Atkinson,
Morten, and Sue, 1979), Gushue notes that individuals from a minority
culture assume a variety of positions toward their own culture and toward
the dominant culture in which they are immersed. Cultural-identity
development models hold that these positions assume predictable forms and
that these forms evolve in predictable sequences. Thus, individuals, say
within a given family, can be compared as to their relative levels of
cultural-identity formation. By attending to the family dynamics resulting
from the interplay of family members’ varying levels of cultural-identity
formation, therapists can construct an assessment of a given client family
that is more genuinely attentive to the local and particular than would be
possible were the assessment based on the assumption that the family as a
whole subscribes to the norms prescribed by the family’s ethnic culture.
Practitioners of the postmodern, idiographic models that we
described earlier in this chapter would likely judge that Gushue (1993) has
been only partially successful in his attempt to increase the idiographic
component in the nomothetic-idiographic blend that he has proposed. Of
concern to these practitioners would be Gushue’s unquestioning reliance on
developmental thinking in his model. A postmodern perspective would
view developmental thinking as nothing more than an artifact of the
dominant, Western, positivistic, professional cultural discourse. Ironically,
in using the concept of cultural-identity development in his attempt to
render family assessment more attuned to the local, Gushue can be viewed
as having become an unwitting exponent of the imposition of a therapistdriven, “foreign” cultural discourse on minority families. His model can
13
still be criticized for favoring the nomothetic in its nomothetic-idiographic
blend.
Structural Family Therapy: A
Nomothetic-Idiographic Rendition
We propose yet another scheme for systematically blending
nomothetic and idiographic elements in the task of assessing families. This
scheme has been constructed in much more explicit dialogue with the
postmodern, idiographic models of family therapy summarized earlier in
this chapter than were the nomothetic-idiographic blends just referenced.
As a result, our scheme is constructed along significantly different lines
from these other blends. The nomothetic elements in our blend come from
structural family therapy (SFT). The idiographic elements are heavily
indebted to the collaborative language systems model of family therapy.
Nomothetic Elements
Along with most of the classic models of family therapy, SFT views
the family as a system. Understanding the family as a system entails seeing
its members as being so interconnected as to constitute, quite literally, a
single, multibodied organism (Minuchin and Fishman, 1981). Behaviors
enacted within the family are seen as being cocreated by all the members of
the family. As a result of this unity of functioning, change in one area of the
family is seen as inevitably causing compensation in another.
Over time, every family develops patterns of interaction, along with
stories that both justify and explain these patterns (Minuchin et al., 2006).
SFT uses a structural frame to make sense of these patterns. Family
structure is not something that SFT therapists can directly observe or
discover. Therapists are simply privy to their observations of family
members’ interactions, which SFT brings into the therapy room through its
signature technique of enactment. Upon these observable data, SFT
therapists impose a conceptual framework that allows them to organize the
complex and often confounding world of family interaction and
communication. The major components of this framework are the concepts
of subsystems, boundaries, and circular causality (Minuchin, 1974).
14
Subsystems
It occurs naturally in families that some members unite with others
to perform a certain function or engage in some shared activity. Such
functionally united segments of the family system are what SFT refers to as
subsystems. As families develop and change over time, different
subsystems come into play and exert more or less influence at various
points in the family’s developmental trajectory.
Two adults who join together for the explicit purpose of forming a
family create a spousal subsystem. (While this term, canonized by long
usage by SFT therapists, implies that the adults are married, and even
heterosexual, such, of course, need not be, and frequently is not, the case.)
Each adult brings into the relationship a set of values and expectations that
must be reconciled if they are to live together with a degree of harmony. In
order to achieve this harmony, a set of rules is established, some of which
are explicitly negotiated (Jane goes food shopping on Saturday morning,
while Dick does the laundry), while others remain implicit (when Dick is in
an angry mood, Jane goes out with one of her friends).
Precisely because its members usually carry differing relational
expectations, harmony in the spousal subsystem is not easily achieved.
Some degree of conflict between the partners is to be expected, and
resolution of a given set of conflictual issues is likely to be followed in
fairly short order by the emergence of another. As with all else, the spousal
subsystem develops patterns for dealing with conflict. It may be dealt with
through direct exchange, and so remain contained within the subsystem.
Alternatively, and less functionally, one or both members of the spousal
subsystem may seek allies outside the subsystem. In another potentially
dysfunctional arrangement, the spousal subsystem may stabilize a pattern of
detouring away from conflict by turning toward other things or people as a
distraction. Children, if present in the family, frequently serve as the focus
toward which spousal conflict is detoured.
If children do enter the family, whether by birth, adoption, or
fostering, a new set of functional demands, focused on child rearing, is
brought to bear on the system, giving rise to a new subsystem, the parental
subsystem. In a nuclear family, the parental subsystem is usually composed
of the two adults who joined together originally to form the family. It may
also include many different people: grandparents, aunts or uncles, an older
child, a live-in nanny, or anyone else designated to guard, discipline, and
nurture the younger and more vulnerable family members.
In assessing families, SFT therapists pay careful attention to the
parental subsystem. What is its constituency? Is anyone included who
15
might not be appropriate (perhaps a younger, parentified child)? Is anyone
excluded who might serve as a resource (perhaps one of the adults)? How is
authority exercised by the subsystem? If there are two parents present, is
authority in the hands of both, or of just one to the exclusion of the other?
Do the members of the parental subsystem work together as a team in
managing and disciplining the children, or is the authority of one member
of the subsystem undermined by another member?
When the constituency of the parental and spousal subsystems is
identical, it can be expected that problems in the spousal subsystem might
reduce the effectiveness of the parental subsystem. Specifically,
mismanaged conflict in the spousal subsystem could undermine the
effectiveness of the parental subsystem. As noted, the triangulation of
children into spousal conflicts is quite common. For example, one parent
might enter into a coalition with a son or daughter against the other parent.
The SFT therapist would see such an intergenerational coalition as
potentially problematic as a result of the disempowering of a parent and the
inappropriate empowering of a child that it produces.
In families with children, the third major subsystem of the family is
the sibling subsystem. While children in a family (optimally) live most of
their lives under the umbrella of care and management provided by the
parental subsystem, they do—or should—have significant interactions
among themselves that do not directly involve the adult caregivers. Siblings
play together, go to school together, hold secrets together. The sibling
subsystem is the laboratory in which children can develop the interpersonal
skills required for relating to peers throughout the life span. However, it can
serve as such a laboratory only if its integrity is guarded within the family
system. One reason that intergenerational coalitions, detouring of spousal
conflict toward children, and the parentification of young children are
deemed dysfunctional by SFT therapists is the violation of the integrity of
the sibling subsystem that all of these structural arrangements entail.
Boundaries
The major component of family assessment in SFT is examination of
the relationships among the different subsystems in a family. In making this
examination, the SFT therapist relies on the concept of boundaries.
Family subsystems are differentiated by boundaries, invisible
barriers that demarcate and define the relationship among the different
subsystems (Nichols and Schwartz, 2006). Moreover, the family system as
a whole is differentiated by a boundary that creates both psychological and
physical distance between the family and the extrafamilial world. For
16
example, a family may have a rule that prohibits the sibling subsystem from
having friends stay past 6:00 P.M. on weekdays, since the family eats dinner
together and by themselves. This would contrast with a family that has no
set time for dinner and cares little whether there are others in the home
while family members are eating.
In SFT, boundaries are assessed along a continuum from rigid to
diffuse. A rigid boundary between subsystems produces a disengaged
relationship between the members of the respective subsystems, while a
diffuse boundary is productive of enmeshed relationships. For example, the
SFT therapist would see the overinvolvement of one or both parents in the
lives of their children as the result of a diffuse boundary between the
parental and sibling subsystems. Other signs of diffuse boundaries in a
family system might include a lack of privacy in the home, family
members’ finishing one another’s sentences, and parents who are constantly
in school or calling the school to check on their child’s welfare. Signs of a
rigid boundary between the parental and sibling subsystems can include
disregard for a child’s difficulty, unreturned telephone calls from school
personnel, repeated inability to make meetings concerning the child, and a
general inability to foster support when needed.
SFT assumes that problematic families have subsystem boundaries
that are too diffuse or too rigid. Children who are enmeshed with one or
both parents receive wonderful care and support but at the expense of
independence and autonomy (Nichols and Schwartz, 2006). Problems arise
when such children are unable to negotiate the demands of the outside
world. They might be afraid to go to school, and if they do go to school,
they might not have the courage to meet the demands for socialization.
Parent-child enmeshment also entails negative impacts for the spousal
subsystem, allowing little time and opportunity for the spouses to be alone
with each other. The likely result is a nonfulfilling spousal relationship.
In contrast to families with diffuse boundaries, families with rigid
boundaries have members who are independent of yet isolated from one
another. On the positive side, children from disengaged families learn to be
resourceful and not to shy away from tasks that require perseverance and
mastery. On the negative side, such children will not have experienced the
warmth, nurturance, and affection so prevalent in enmeshed families.
Both disengagement and enmeshment can, and frequently do,
coexist within the same family system. For example, one parent might be
enmeshed with the sibling subsystem, while the other is disengaged. Father
might be enmeshed with his daughter and disengaged from his son. Mother
might be overinvolved in her job and underinvolved at home. Whatever the
constellation, SFT relies on the concept of boundaries to assess the overall
17
degree of enmeshment and disengagement among the various subsystems
and their individual members.
Circular Causality
The concept of circular causality is central to systems thinking and
the assessment process in SFT. In opposition to a linear understanding of
behavior (A causes B, which causes C), which searches for explanations in
the past, circular causality views behavior within a system as being
maintained in the present by repetitive, circular interactional loops. The
linear understanding of A causing B causing C is thus replaced by the
understanding of A causing B, which in turn causes A.
A system regulates itself through circular causality. Consider the
simple example of a thermostat used to heat and cool a room. The
thermostat instigates heating if the room temperature drops below a set
point, and it cuts off heating if the temperature rises above another set
point. Through this feedback loop, the thermostat maintains the temperature
in the room within a constant range.
When applied to families, the concept of circular causality produces
the view that a family member’s behavior is both caused by and causes the
other members’ behavior. From the perspective of SFT, it is never a
question of “who started it” or “who is to blame,” since all family members
are assumed to be coresponsible for maintaining any and all patterned
behaviors enacted within the family.
A simple example of circular causality might be found in a spousal
subsystem that is organized into the well-known pattern of distance-andpursue. The pursuer pushes for closeness, while the distancer pulls back.
The pursuer feels more of a need for connection and pursues harder. The
distancer now feels even more need for space and distances even more. A
more elaborate example involves a punitive father and his acting-out son.
The son’s acting out causes the father to be punitive, which in turn elicits
further acting out on the son’s part. Mother intervenes by coddling her son,
since she cannot stand seeing him cry. Father feels undermined and
punishes the son even more.
Idiographic Elements
SFT has well-defined notions of how it is that family systems
malfunction. The presence of excessively rigid or diffuse boundaries
between subsystems, frequently linked to the mismanagement of conflict in
the spousal subsystem, is deemed to constitute dysfunctionality within the
18
family. Dysfunctional structural arrangements are assumed to be
maintained in the here and now through multiply linked and nested
interactional loops of circular causality. Family assessment in SFT boils
down to a search for the presence of rigid or diffuse subsystem boundaries
within the client family. Both clinical experience (see, for example,
Minuchin, Nichols, and Lee, 2007) and outcome research (see, for example,
Szapocznik and Williams, 2000) suggest that therapy based on this
assessment scheme is effective with families within a broad range of
cultural contexts.
However, therapy, even when it is effective, can still be colonizing
and impositional. And it must be admitted that, left unchecked, the
nomothetic elements in SFT place the model at risk for fitting any family
that crosses its path onto the Procrustean bed of its assessment scheme,
running roughshod, in the process, over whatever is idiosyncratic to the
family.
To reduce this risk, we have incorporated some idiographic elements
into the SFT assessment scheme. These elements are intended to provide
checks and balances against the universalizing tendency inherent in SFT’s
nomothetic outlook. As we will now describe, these elements increase
SFT’s sensitivity to the local and particular by providing strict criteria
regarding when it is and is not appropriate to assess a family and by
prescribing how the results of assessment should be communicated to a
family.
To Assess or Not to Assess
Family dysfunctionality, in the view of SFT, is associated with
excessive rigidity or diffuseness in a family’s subsystem boundaries. But
what constitutes “excessive”? Those who subscribe to the intellectualclinical tradition instigated by Monica McGoldrick would answer that a
family’s ethnicity is the crucial determinant of what constitutes normal and
excessive in this matter of the permeability of subsystem boundaries. We
have already observed that this approach to norming can be criticized for
still privileging the universal-nomothetic over the local-idiographic, as a
result of its lack of attentiveness to salient within-culture differences.
Inspired by Harlene Anderson’s collaborative language systems
model of therapy, which we mentioned earlier in this chapter, we propose
that it is the client family itself that must set the standard against which the
relative functionality of its subsystem boundaries should be judged. It is the
family that should make the determination that its boundaries have become
excessively rigid or diffuse.
19
We consider that a family communicates such a determination when
it defines into existence a problem that it judges merits therapeutic
attention. Following the collaborative language systems model, we assume
that problems do not have any kind of objective existence. Like everything
else in the human world, a problem exists only when it is consensually
defined into existence by members of a system. A behavior, feeling, or
thought is a problem only if some members of the system in which the
behavior, feeling, or thought occurs define it to be problematic. Thinking in
this way, Anderson and Goolishian (1988) see a family’s defining into
existence of a therapy-meriting “problem” as an “alarmed objection” by the
family—the family’s way of signaling that it has determined that something
is amiss within the system.
If a family with a “problem” consults with an SFT therapist, that
therapist will bring to the encounter several preformed ideas of where to
look within the family for the malfunction whose existence the family is
signaling by its definition of a problem. The therapist assumes that by
defining a problem into existence, the family is signaling that its subsystem
boundaries have become excessively rigid or diffuse according to the
family’s own idiosyncratic standards. The therapist will thus apply SFT’s
assessment scheme to ferret out the enmeshment or disengagement, whose
presence the family itself has signaled by its generation of a problem.
The nomothetic elements in the SFT assessment scheme tell
therapists where to look within a family for dysfunction. However, in the
perspective that we are presenting here, it is the family itself that signals
whether a therapist should be looking for dysfunction in the first place. The
SFT assessment scheme is radically dependent for its activation on a
family’s voluntary presentation of itself for treatment, around a presenting
issue that the family itself has determined to be problematic. Thus, we view
the SFT assessment scheme to be an intrinsically clinical instrument. We do
not believe that the scheme should be used to assess and categorize families
outside the therapeutic context. Any such extratherapeutic use runs an
excessive risk of turning into an exercise in cultural colonialism.
Moreover, the mere presentation of a family for treatment is not
sufficient to justify the activation of the SFT assessment scheme. Before
engaging in assessment, the therapist must assiduously determine whether
the family’s presentation for treatment is genuinely voluntary and whether
the problem presented as a focus for treatment has genuinely been defined
into existence by the family itself. Poor families and families whose
members belong to ethnic minority groups are notoriously susceptible to
having their inner world judged and defined by outsiders (Minuchin,
Colapinto, and Minuchin, 1998; Minuchin et al., 2006). Outside agents, like
child welfare workers, family court judges, probation officers, and school
20
personnel, frequently refer these families to treatment to deal with issues
that the agents, not the families themselves, have defined to be problematic.
Any treatment focused on such presenting problems necessarily will be an
exercise in social control, not genuine therapy.
Thus, before embarking on the task of assessment, it is incumbent on
the therapist to join with a client family sufficiently to allow its real
customership for therapy to be revealed. If it turns out that the family has
presented itself for therapy under duress, the therapist can offer his or her
services to help the family remove itself from the supervision of the outside
agent who has pushed the family into therapy. In such circumstances, the
therapist functions as a culture broker rather than as a therapist, properly so
called. He or she helps the family gain clarity regarding that aspect of its
functioning that has run the family afoul of societal powers that be. Without
either canonizing the standards being employed by these powers or
negatively judging the family’s own idiosyncratic standards, the therapist
portrays the family’s predicament as resulting from an inadequacy of fit
between the family’s local culture and the dominant culture in which it is
immersed: “You are caught between two cultural worlds, and an either-or
solution is not viable” (see Simon, 1993). The therapist encourages the
family to find alternatives in its repertoire that will assuage the concerns of
the outside agents while still preserving the family’s sense of identity. He
or she provides support as the family engages in this search for a better fit
with the dominant culture. However, the therapist assiduously avoids
assessing the family’s structure.
It is our experience that many families that find themselves in this
predicament welcome an offer by the therapist to function as a neutral,
nonjudgmental culture broker. Experiencing the therapist as benign and
empathic, some families even go on to volunteer, after a period of time has
elapsed, that they do in fact have some problem, different from the one that
has occasioned the mandate into treatment, that has been concerning them
and that they would like to make the focus of treatment. If such a
presentation of a genuinely self-defined problem is forthcoming, only then
should the therapist begin to assess the family using the SFT scheme.
Otherwise the therapist should restrict herself or himself to helping the
family maneuver itself out of the intrusive control being exercised by
outside agents.
21
Communicating Assessment to the Client
Family
Much of what is written about SFT focuses on the model’s
conceptualization of family dysfunction. Whereas it cannot be denied that
this conceptualization exerts a powerful influence over the therapeutic
process prescribed by SFT, that process is equally influenced by two
assumptions about families rarely highlighted in the literature about SFT:
the assumption of competence and the assumption of uniqueness (Simon,
1995).
SFT’s assumption of competence is that every client family brings to
the therapeutic encounter sufficient resources to remediate whatever is
amiss in the family’s structure (Minuchin, 1974; Minuchin and Fishman,
1981; Minuchin and Nichols, 1993; Simon, 1995). The assumption of
uniqueness is the assumption that “whatever characteristics it may share
with other families, each family is fundamentally unique” (Simon, 1995, p.
20; see also Minuchin and Nichols, 1993). It is the assumption of
uniqueness that makes SFT ripe for being cast into the kind of nomotheticidiographic blend that we are presenting here.
These assumptions exert a powerful influence over SFT’s view of
the general goal of therapeutic intervention. Specifically, the assumptions,
operating in tandem, lead the SFT therapist to see her or his interventive
role in therapy to be to activate what is already there in the client family
rather than to supply what is missing.
The SFT therapist’s desire to position himself or herself as an
activator of a client family’s latent, idiosyncratic resources exerts a
determinative influence on how the therapist executes the task of
communicating assessment results to the family. Such communication
needs to occur in a way that will orient the family toward its own reservoir
of resources rather than toward the therapist as a potential expert provider
of “answers” or “healing.”
To accomplish such communication, we advocate that the therapist
use another element drawn from the idiographic collaborative language
systems model of therapy. We noted earlier in the chapter the language
systems therapist’s signature stance of keen attentiveness to the
idiosyncratic language used by clients to make sense of their own situation.
It is our view that the SFT therapist should adopt this same stance when
communicating the results of assessment to families.
Were the therapist to communicate assessment results using the
technical language that we have employed in this chapter in our description
22
of the SFT assessment scheme—the language of systems, subsystems,
boundaries, enmeshment, and disengagement—the therapist would almost
certainly maneuver himself or herself into precisely the “expert” position
that he or she wants so much to avoid. The journey from assuming such a
position to engaging in therapeutic colonialism is an unfortunately all-toobrief one.
Instead, it is our view that the therapist should attend carefully to the
client family’s own idiosyncratic language, searching that language for
stories, images, and metaphors that refer, in ways that are already
meaningful to the family, to those aspects of the family’s functioning about
which the therapist wants to talk as he or she shares with the family the
results of the assessment. If it receives the results of the assessment cast in
its own native language, the client family will be less likely to respond to
the assessment by concluding that it needs to import some kind of “foreign”
knowledge or expertise in order to resolve its presenting problem. The
family is more likely to see itself as the SFT therapist does: as competent to
crystallize its own home-grown alternatives to the dysfunctional
components of its structure.
Case Illustration
We conclude this exposition of our SFT-informed, blended
nomothetic-idiographic assessment scheme by describing briefly how it
was used in the treatment of Curtis and Elana.
case extract begins
The first task for the therapist dictated by our scheme is to decide
whether to assess or not to assess. The crucial determinant the therapist
uses to make this decision is whether the family presenting itself for
treatment is doing so voluntarily around a self-defined problem.
Both the content and the tenor of the therapist’s initial telephone
conversation with Curtis strongly suggested to the therapist that this was
indeed a couple presenting itself voluntarily for treatment. During the
conversation, Curtis expressed what sounded like sincere regret for having
had yet another extramarital affair and real concern that this might have
been the straw that had broken the back of the marriage. He described
both himself and Elana as anxious to begin a therapy that would help them
save their threatened marriage.
23
Early in the first session, Elana confirmed the voluntary status of her
participation in therapy. She reported that she had spoken with no one
other than Curtis about his affair and that her decision to enter couple
therapy was entirely her own. Meanwhile, Curtis’s behavior during the
opening moments of the session did nothing to alter the therapist’s sense
that he was genuinely desirous of a therapy aimed at delivering his
marriage from the dangerous straits in which it was floundering.
Convinced that the couple system before him was presenting itself
voluntarily for treatment around a problem that it itself had defined into
existence, the therapist decided that it was appropriate to embark on a
structural assessment of the system. At the first opportunity, about a third
of the way through the first session, he elicited an enactment between
Curtis and Elana. The therapist asked the spouses to talk with each other
about how they thought they were doing as a couple in the aftermath of
Curtis’s most resent affair.
As the therapist watched the enactment, he was struck by two
characteristics of the interaction between Curtis and Elana that he was
observing. First, he noted Elana’s relentless pursuit of information from
Curtis, information that Curtis just as relentlessly refused to provide.
Second, he noted the halting nature of the interaction, which was filled with
embarrassed pauses and averted glances on the part of both spouses.
To test whether these structural characteristics were tied to the particular
subject matter of the first enactment, the therapist elicited a second one,
focused on the more mundane content of the couple’s division of
household responsibilities. Around this very different subject matter, Curtis
and Elana interacted in exactly the same way that they had around the hotbutton issue of Curtis’s affair. When the interactional pattern repeated itself
in a third enactment, focused on how the couple relates to members of
Curtis’s family, the therapist felt it reasonable to conclude that the pursuedistance dynamic that he had observed in all three enactments was a
stable structural element in this couple system. True to SFT’s systemic
thinking, the therapist assumed that this dynamic was maintained by
circular causality, with Elana’s pursuit of Curtis eliciting and maintaining his
withdrawal and Curtis’s withdrawal eliciting and maintaining Elana’s
pursuit.
As impressed as the therapist was by the ubiquity of Elana and Curtis’s
pursue-distance dynamic, he was equally, if not more, impressed by how
anxious the couple was to exit the dynamic once it had begun. With each
halt and uncomfortable silence in the conversation, of which there were
many, the spouses attempted to disengage from each other. As did their
interaction with each other, these exits from interaction assumed an
24
unvarying pattern in all three enactments. When the conversation between
them lagged, Elana would become pensive, apparently involved in an
internal dialogue with her thoughts and feelings. Curtis would attempt to
engage the therapist in light, jocular banter. The therapist was struck by
how easily conversation came to Curtis when the therapist made himself
available to interact with him. Gone were the embarrassed pauses that
peppered Curtis’s attempts to talk with his wife. Replacing these was a
smooth, genuinely engaging conversational style. When the therapist
asked Elana if this was the way that Curtis talked with people, she replied
sadly, “With everybody but me.”
As the first session was nearing its end, the therapist felt that he had
gleaned sufficient evidence from his experience of how Elana and Curtis
had interacted with each other and with him to construct an initial map of
this client system’s structure. The therapist assessed that the external
boundary around this spousal subsystem was excessively diffuse. Curtis
clearly interacted more easily with the therapist than he did with his wife,
and this pattern appeared to be isomorphic with the way he interacted with
friends, members of his family of origin, and, alas, his lovers. Curtis’s
enmeshment with people outside the marriage was recursively linked to
disengagement between him and Elana. What engagement there was
between the spouses had become organized into a pursue-distance
complementarity, which, far from succeeding in increasing the involvement
between the two of them, had actually served to increase their
disengagement. More disengagement between the spouses led to more
enmeshment between Curtis and people outside the marriage, which led in
turn to more disengagement in the marriage.
The therapist closed the first session by communicating his structural
assessment to Elana and Curtis. He endeavored to do so using elements
of the couple’s own language that seemed to refer to the structural
features that the therapist wished to talk about. The therapist judged that in
their frequent use of the words foreigner, home turf, and needy, Curtis and
Elana were already referring to their pursue-distance dynamic and to the
enmeshment and disengagement to which it was recursively linked. Thus,
he employed this language as he shared with them his view of their current
dysfunctional structure and of the therapeutic work they would need to do
to rectify it:
As you both already seem to sense, you have become foreigners to
each other since your move from Virginia to Curtis’s home turf. You
both seem to want to get closer, but right now, every attempt you make
fails. Your eagerness to be close to Curtis, Elana, comes across to him
as neediness. He’s not sure that he can meet your needs, and he backs
away. Curtis, it is easy for you to back away, because, after all, you
25
are on your home turf. But your backing away only increases Elana’s
eagerness, and she winds up looking even needier to you. Curtis, you
need to retrieve what you did to successfully meet Elana’s needs when
you were not on your home turf and find a way to do those things
again now that you are. Elana, you need to retrieve the less panicked
ways that you used to show your eagerness for Curtis when you were
in Virginia, and you need to give those ways a chance to work now,
even though you’re on his home turf. You both need to help each other
rebuild the sense that you had early in your marriage that ultimately
your relationship is, for both of you, the real home turf.
Conclusion
One way to think about multiculturalism is as an attempt to discern a
fitting relationship between the one and the many, between the universal
and the particular. The idiographic models of family therapy champion that
aspect of the human spirit found only at the level of the local and the
particular. The nomothetic models highlight those elements that are
universal in the human spirit. The models that seek to achieve a systematic
blending of nomothetic and idiographic elements see the essence of
genuinely human accomplishment in the creation of a dynamic balance
between the universal and the particular, the one and the many.
We subscribe to this latter ethos. The SFT-informed, blended
nomothetic-idiographic assessment scheme that we have presented in this
chapter is based on our belief that it is valuable and clinically useful to
think of families as being, all at the same time, both different and the same.
We have presented our scheme in the hope that it will spur others to devise
blended nomothetic-idiographic assessment schemes that are both the same
as and different from our own.
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