A Bowen Family Systems therapist employs concepts of triangles and the family projection process to view a child's symptoms as embedded in the broader family patterns. This article will examine the dynamics of two family therapy cases where parents anxiously asked for their children's symptoms to be fixed. These cases will be used to explore the common presentation in child and adolescent mental health, where the parents are concerned for their children but are also keen not to open their own ‘can of worms’. The presenting problem in the first case was violent hostility between adolescent sisters and in the second case was an adolescent's anorexia. Drawing on client feedback, I reflect on the therapy process behind the divergent outcomes. In case one, the parents were willing to address their own troubled relationship and family of origin, while in case two, the parents discontinued therapy when family of origin dynamics began to be explored. The article suggests how the therapist can evoke parents' curiosity about their role in anxious family patterns, without them feeling blamed.

Asperger's syndrome (AS) as a diagnostic category has gained enormous popularity and the label is being applied with increasing liberality. While greater awareness of the disorder may be of advantage to certain children and their families, we argue that the over-inclusive use of the diagnosis may also lead to professional conflicts and ethical dilemmas. Perhaps most concerning of these is that diagnostic ‘generosity’ may exclude children from treatments they would have received if an alternative formulation had been considered. We present clinical scenarios, with special consideration of contextual and intergenerational influences on the children's early lives, and offer alternative conceptualisations. We argue that the new ‘epidemic’ of Asperger's should not be allowed to compromise our professional standards. Assessment should always include a detailed family and developmental history. Finally, we would be interested in feedback from clinicians working in this field.

What does it mean to be a professional therapist? This paper explores some of the personal and cultural pressures that influence how we see ourselves as professional therapists. It then explores how these pressures impact upon our capacity to protect children and ourselves.

Originating as a plenary address, this article reviews the enduring contribution of family therapy, and asks how it might best be preserved into the future, given that family therapy itself is no longer seen as ‘news-worthy’. The author makes three recommendations: that all future social workers be trained to conduct a three-session structured family assessment; that all future family therapists be required to participate in a Yalom-type group therapy experience; and that one member of every child mental health and child protection team be trained to convene and chair interagency case conferences capable of building trust and working towards open communication. A rationale for the three recommendations is provided, in terms of key principles common to family and group work.

From a philosophic perspective on clinical practice, anorexic women and their therapists are at risk of being caught in the dichotomy between mind and body that has characterised Western thought, at least since Descartes. If doctors and patients collude in an obsession over weight and refeeding, arising from this flawed dichotomy, it may lead to flawed treatment. Patients describe eating restriction/going on hunger strike as a desperate attempt to achieve a sense of self that can develop into an addiction to the starving state. The extent to which contemporary treatments address these issues is examined.

This article presents a qualitative study of the subjective experiences of 24 Chinese adolescents and young women who have been suffering from anorexia nervosa and who have received family treatment from a university-based family treatment centre in Hong Kong. In-depth post-treatment interviews were conducted and have been transcribed and thematised using content analysis. The narratives that have emerged have facilitated hearing the clients' and their family members' voices, especially in the areas of (a) perceived concepts of family therapy, (b) the perceived therapeutic relationship and its linkage to positive change, (c) perceived intervention strategies as employed in family treatment, and (d) the participants' own role in problem-solving. The study has enabled the author to refine the family treatment model, which has been adapted from the Micucci's (1998) model, with additional components introduced by the author to enhance family treatment in a Chinese context.

This article presents an historical analysis of the development of research and research methodologies in an Australian context. The Australian and New Zealand Journal of Family Therapy was chosen as the site of the analysis. The first section of data consists of the articles that represent themselves as ‘research’ in the period from 1979 (the journal's inception) to 2000. These texts have been analysed using bibliometric analysis. The second section of data consists of commentary articles about research in family therapy. This data has been analysed using discourse analysis. Overall, I have been interested in how family therapists have defined ‘research’; how family therapists have chosen to inquire; representations of the researcher in Australian family therapy; associations between theoretical or clinical developments and the methodologies that have been chosen for inquiries. Findings from the study reveal very limited representations of research in the journal for the period under review, and an apparent struggle for family therapists to undertake a discussion about what research actually is. Questions are raised around how this has occurred, and some ideas are presented as to how research knowledges can be included in debates around theory diversity in family therapy.

This article explores some of the uses of absurdity and the unexpected in psychotherapy. Case examples are used to ground the discussion of some key ideas that inform an understanding of how absurdity and the unexpected might serve as catalysts or primers for change in the psychotherapeutic context. Erickson's confusion technique and some ideas derived from Bateson's understanding of cybernetics also serve an explanatory purpose.

Individuals with borderline personality disorder (BPD) struggle with unbearable emotions that arise out of interpersonal difficulties. Self-harm and suicidal behaviours serve to regulate these emotions and to gain a sense of well-being and control in a treatment context where hospital admissions are avoided by mental health services. Clinician engagement with families may be constrained by their knowing the accepted etiology of the disorder, which includes a causal link with the family environment. Other constraining factors include the negativity of those with BPD toward their family, and their clinicians' diagnostic uncertainty or confusion. This qualitative study explored the experience of families whose close relative with BPD has a long history of self-harm and/or suicide attempts. Family members were found to have chronic and traumatic stress. Family roles and relationships were strained, as were relationships between the family and the mental health system. The findings of this study indicate that treatment for BPD needs to adopt a systemic approach that considers individuals and their significant family relationships, as well as relationships between the family and treatment providers.

In the last decade there has been increasing interest in working systemically with groups of families. Multiple family groups (MFGs) have been used in mental health settings with schizophrenia, eating disorders and drug and substance abuse. This article describes the MFG program used in Higher Ground Alcohol and Drug Rehabilitation Trust, a rehabilitation centre in Auckland, (New Zealand). Higher Ground provides an 18-week residential therapeutic program for people with a severe substance abuse disorder. The MFG in Higher Ground focuses on developing better communication patterns and better boundaries between family members, fostering mutual support, and promoting self-responsibility.

Family histories of abuse and neglect are common among persons with substance addictions. Clearly such family backgrounds impact on future lifestyle choices. How this early life experience then impacts on the substance user as a parent and on their children has not been considered in the literature in any detail. Clients of local community drug services were invited to participate in a study evaluating the family life of parents who were dependent on illicit substances. Fifteen parents participated in a qualitative, longitudinal study about their family life, treatment and drug of choice. Four aspects of parental perception of family life were examined: the perceived impact of the family of origin on the parent drug user, self-perception, the impact of parental illicit drug use on the family environment, the impact of parental illicit drug use on children. For parents struggling with a substance addiction, it would seem that recovery has much to do with differentiation and gaining a sense of agency.

Ideally, therapeutic practice and the underpinning theories which guide our activity are closely linked, yet in everyday work it is sometimes difficult to directly connect one to the other. The following transcript and commentary aim to closely align the systemic, cybernetic ideas drawn from the work of Gregory Bateson with the practical activity of the therapist. It draws on ideas of therapeutic system, negative explanation and restraint to provide a micro-analysis of a segment of an interview with a woman and her two children who have shared horrific experiences.

A recent project sought to clarify how psychotherapists and mental health workers understand psychosocial health and pathology. In this enquiry, I paid particular attention to the client's interpersonal networks: did the professionals actively consider, and if so to what extent, ‘intimate social and family relationships’ in constructing their understanding of the presenting problem and in the process they used for goal setting. Twenty-two semi-structured interviews were undertaken, eleven with psychotherapists and eleven with mental health workers. Across both groups, interviewees tended not to see their clients as embedded, relational entities, but primarily, often quite exclusively, as autonomous beings. Second, inter - viewees accorded a high value to the importance of ‘the therapeutic relationship’. Is it possible that the emphasis practitioners place on ‘the therapeutic relationship’ has the effect of marginalising the attention that is given to the client's significant-other network?

This study documents how residents experience Multiple Family Group (MFG) treatment in an 18-week residential therapeutic program for people with a severe substance disorder. Individual in-depth interviews with nine residents and three ex-residents of European descent were undertaken, and analysed using a descriptive thematic analysis. Results indicate that, prior to taking part in the program, their relationships with their families were seriously damaged and their situations often appeared complex and hopeless. After attending the MFGs all of the participants of this study experienced a number of positive changes in their relationships with their family members and partners. All interviewees said that they had gained more awareness about their interactions, better communications skills and were able to integrate these skills into their relationships with their families and partners.

The impact of sibling sexual abuse (SSA) has been culturally and therapeutically minimised and has received scant research attention. Furthermore, prior research has focused upon the separate experiences of the victim or the offender, or upon seeking family dysfunction explanations. In contrast, this qualitative study attempts to understand the experiences of all family members (victims, offenders, parents and other siblings) when SSA is disclosed. The pathway to recovery for each family member is identified. A systemic analysis of these (often conflicted) pathways of recovery provides some surprising findings and contributes to an understanding of the difficulties facing families in this situation, the constraints on family support and connectedness, validation for the victim and offender accountability.

Amplifying deviations in family interactions is a critical skill in family therapy, and one that can be implemented following the first reflecting team intervention. This paper will provide trainees with a series of practical guidelines for amplifying deviations, derived from an integration of several models of family therapy. Solution-focused and narrative questions are employed systemically, with the aim of magnifying virtuous, rather than vicious cycles of interaction. A theoretical rationale for deviation amplifying and a brief case vignette will also be presented.

Exploring is the optimum mindset for the psychotherapist. From the outset, the project of Family Therapy offered both personal and theoretical support for this position. But have we lost the excitement of exploration in the conservative, correct and individually oriented world in which we practise? And does our style of communication hinder more than refresh us?

Nada Miocevic is a social worker and family therapist who trained at Zagreb University in Croatia and at Melbourne University in Victoria, Australia. She completed her training in family therapy in 1975 at the Bouverie Centre, Melbourne. Since migrating to Australia in 1967, her work with migrant and refugee families has taken her throughout Australia and overseas. Currently she is in private practice. Her work involves conducting training courses in supervision and supervision of supervision, as well as her continuing work with families who experience long-term illnesses.

My feminist, narrative research comprises a crosscultural narrative analysis of 11 Mongolian and 11 Australian women's stories of survival, recovery and remaking of self, following intimate partner violence. With a major focus on narrative identity, the research process involved me as researcher, as well as the participants themselves, bearing witness to and reflecting on their stories. While similarities between the Mongolian and Australian stories stood out above differences, there was some evidence that the Mongolian women had moved further away from the violence and its effects than their Australian counterparts. Perhaps the cohesive nature of the Mongolian women's family supports strengthened their narrative identities, enabling their greater resilience.