Assessing Families and Couples: From Symptom to System

The book starts with a four-step model for assessment of families and then proceeds in a fascinating format of case studies. Each study includes therapist reflection on the interactions and an evaluation of family organization, individual perspectives, strategies of intervention, and techniques. The richness of Minuchin's life and experience enhances each aspect of the book and its instruction. The model provides a framework within which to use a multitude of therapeutic tools. Joining, respecting, reframing, challenging assumptions, showing interest and curiosity, and an extraordinarily apt use of metaphors characterize the therapeutic sessions included in the book. The cases are selected from different cultural milieu, demonstrating the transcultural application of the structural model. This book gives me a model, theoretical basis, and rich personal application. I felt like I've sat with and been mentored by a master through all of the examples Chapter 1 introduces the four-step model with an historical review of family therapy and Minuchin's personal history of 50 years as a therapist. "Once you accept that a therapist is a partial and biased instrument, you recognize the importance of self-knowledge, and you can borrow freely from life. It is part of the use of self that family therapists are trained to focus on" (5). Step one: Opening up the presenting complaint. This includes joining all of the family participants and challenging the narrowness of the understanding with respect, reframing, and giving close attention to context. Step two: Highlighting problem-maintaining interactions. What are the family members doing to perpetuate the problem? "The trick is to help clients see how their actions may be maintaining the problem without provoking resistance" (9). "Almost always the therapist will find a part, the healing part of family members ready to ally themselves with the process of helping.... This second step relies on the assumption that family members will change their pattern of relating if they see themselves as able to help the identified patient" (10). Step three: A structurally focused exploration of the past. `How did your parents select for you this particular pair of glasses?' How did you happen to develop 8 arms (or 3 heads) or this particular orientation? In this step the children are an audience to their parents' stories. Step four: an exploration of alternative ways of relating. "Without this step, which turns the process of assessment from an operation performed on families into an operation performed with them, therapy often becomes a process of pushing people where they see no reason to go" (11). "...A therapist is a changer with limited options who will be effective only if he or she can disrupt the family norms that maintain their assumptions.... Change...is a collaborative enterprise, in which to be effective a therapist needs to accommodate to family members, join with them, and expand both his

This book has helped me so much with working wiht my families in famioy therapy. Clear wording, good examples, step by step.