This dissertation intends describing and understanding my development as a therapist over a two year period. The question which prompted the research is to what extent the therapist directs change within the therapeutic process. It therefore considers the issue of intervention in therapy. The social constructionist theory is utilised to understand more fully the issues around intervention in therapy. A qualitative research methodology is followed, which has as its foundation an emergent design. The raw data takes the form of a journal, which is a case determined diary. The conclusions drawn at the end of the study are idiographic and reflective. / Psychology / M.A. (Clinical Psychology)

M.A. (Clinical Psychology) / Postmodernistic thinking supports the existence of various realities rather than the existence of an universally accepted objective truth. Knowledge is seen as an aspect of a constructed truth which may change over time, context, therapist and client and is therefore relative. An ethical approach, according to which the observer takes responsibility for his participation in what he observes, replaces the search for "the cause" or "the truth" constructionism and ecosystemic thinking are offered as ways of creating a postmodernistic interpretive framework. In using these frameworks or ways of thinking, the observer's participation in what he observes, as well as the existence of multiple realities and the influence of context, become recognized. The therapist that functions according to a postmodernistic perspective, gives up the idea that therapy is only about diagnosing an objective static condition. The therapists acknowledges that the observed condition always exists within the interaction between people. The therapist assumes a co-operative, respecting, therapeutic stance. The therapist sees himself as a catalyst rather than an expert who forces the therapy in a theoretically chosen direction. The therapist refrains from prescribing solutions, relying rather on the client himself to find new options and realities. Although this thesis focused primarily on a critique of Selvini Palazzoli's theoretical approach, it also comments on the pragmatic application of theories in general. A postmodernistic framework is offered as a broader more functional framework under which a variety of theories can be applied. within this framework already existing theories can be reconsidered and differently applied without rejecting their praqmatic value. A systemic perception of changing ideas replaces a systemic perception of things or objects. A debate about which school of theory is the most effective in dealing with a specific client, is replaced by an ethical approach according to which the observer takes responsibility for his choice of lenses in making distinctions and decisions.

This study evaluated the relationship between two supervision models (live or delayed) to structural family therapy outcome. Eighteen families participated in this study for a maximum of ten family therapy sessions. Two indices of change were measured before and after family treatment, resolution or non-resolution of the family's presenting problem, and changes in family structure as measured by the FIAT. The Family Interaction Apperception Technique was used as the pre- and post-treatment measure of family structure. Presenting problem resolution or non-resolution was determined by the family's report and demonstration within the counseling session that the presenting problem was no longer a family concern. Problem resolution was judged by the case supervisor and reported on the Session and Problem Checklist.

M.A. (Clinical Psychology) / TIle phenomenon of incest has been examined from differing perspectives over the past few decades and continues to be viewed from psychodynamic, sociological and systemic viewpoints. The past decade has seen a substantial increase in the volume of literature relating to child sexual abuse which includes incest, confirming that such abuse is a phenomenon which has become virtually endemic to our society. In its examination of incest, this dissertation attempts to, integrate intrapsychic views such as Erikson's (1950) developmental theory with more systemic orientated views such as the interactional view of Watzlawick, Beavin and Jackson (1967). Having criticised traditional views of incest, this dissertation goes further in attempting to integrate both the individual's particular perspective of the traumatic incident of incest during her childhood and how this incident affected her adult life, subsequent interactions and relationships. In integrating the apparently widely disparate approaches, this dissertation attempts to provide an alternative theoretical perspective around the phenomenon of incest. By integrating both psychodynamic (intrapsychic) and interactional (systemic) approaches, this dissertation seeks to avoid the pitfalls of rcification, distortion and reductionism. This dissertation adopted the methodology of a single case study. A clinical x interview was analysed according to Erikson's (1950) developmental stages and these stages were viewed from a systemic perspective. Erikson's developmental stages which are bipolar in nature, were proposed as double binding paradoxical contexts. As such, Erikson's views were seen as metaphors of systemic and heuristic value to the author. This dissertation hypothesised that the therapeutic system was a subsystem in interaction with the abusive subsystem and as such would reflect within its content and process the secrets and interactions of the incestuous family system. In investigating this hypothesis, the interactions between the secret incestuous subsystems and other family subsystems were examined. The findings of this work confirm the hypothesis. It is hoped that the application of this knowledge shall enable therapists and investigators to identify the possibility of incest in the narrative of adults and thereby avoid reports of incest being dismissed, avoided or clouded by scientific discussion. As such, the occurrence of incest, which is often an unmentionable secret, may be addressed and the patterns of incest identified in the initial conversation with the victim.

The purpose of the study was to explore the use of Creative Visualization in the context of Family Therapy for treatment of a family of a child with allergies. Based on a single-case research design, the study included pre- and posttest measures; baseline, continuous, and follow-up self-report of symptoms; plus examination of physician's clinical records to determine the efficacy of the intervention. A further purpose of the study was to explore the possible usefulness of a test being developed on the basis of the Psychosomatic Family Model, the Leuven Family Assessment, as an outcome measure. The subject family was an intact family with one adolescent daughter whose most important allergic symptom was poorly controlled asthma, at least partially due to noncompliance with medical advice. The measures included the Leuven Family Assessment, a measure based on the Psychosomatic Family Model, which has been developed for use with families of children with eating disorders; the Family Adaptability and Cohesion Scale (FACES III), a measure based on the Circumplex Family Model, which is a well-accepted measure of family functioning; symptom self-report; and consultation with the child's physician to report hospital admissions and emergency room visits. The baseline period was two weeks, the intervention consisted of two weeks of Relaxation Training and eight weekly meetings for combined Family Therapy and Creative Visualization, and the follow-up consisted of telephone contact with the symptomatic adolescent beginning fourteen weeks after the last family therapy session and continuing for eight weeks. Post-therapy results show a trend toward expected changes in family structure and functioning and marked improvement in the asthmatic symptoms of the adolescent. Creative Visualization is an intervention tool well worth further exploration in the context of family therapy; and the Leuven Family Assessment merits further investigation and development as an outcome measure. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

M.Ed. / This study investigates the process of structural family therapy with a family from a collective consciousness background. The aim was to explore, describe and explain key-elements that played a prominent part in the process. The rationale for the investigation is derived from changes caused in the South African family by an evolving South African society. These changes influence the effective functioning of families with a collective consciousness regarding traditional social roles and the family's autocratic authority structure. It is therefore imperative that psychologists will be able to adequately counsel these families. Minuchin's structural family therapy approach can address this problem, as its principles are congruent with the world view of collective consciousness. This model, developed in the United States of America, must be researched within the collective consciousness context. Such research will contribute to the adjustment of the approach in order for it to be legitimately used with families with collective consciousness. The report of the study commences with a theoretical framework in which structural family therapy is explained. The development of family therapy, taking into consideration the relationship between family therapy and structural family therapy, is addressed. Basic principles and processes of structural family therapy are discussed. During these processes the family structure and patterns of interaction are explored and analysed. The family is encouraged to change dysfunctional patterns of interaction. The focus then moves to an overview of the South African family with collective consciousness. The family's particular world view with it's characteristics and difficulties are discussed. The theoretical framework is complemented by a chapter on the design of the research, proving the rationale for the choice of format and methods of data collection and analysis. A qualitative, exploratory, descriptive case study of a family with collective consciousness undergoing structural family therapy, was conducted for two months. The establishment of a trust relationship and the exploration of the family structure were key issues. This was inhibited by language differences, participation of the family and ineffective translation, but was rectified by the culturally sensitive approach of the therapist and cooperation from the family. The use of metaphors, especially graphic and projective family drawings, use of space and concrete family sculpting contributed to problem exploration and the modification of dysfunctional interaction patterns. The success of structural family therapy with a family of collective consciousness is indicated by the acceptance of the therapist as a confidant and friend of the family. Finally, conclusions and recommendations were made regarding the use of structural family therapy with a family from a collective consciousness background.

M.A. / Family therapy came into being in the late 1950's, and was developed by a heterogenous group of investigators, working in distinctly different contexts and with different purposes. One of these intellectuals saw a family as a system, a cadet of ideas. Another one saw families as collections of individuals struggling to balance feelings, irrationalities and desires. (Nichols M.P. 1 Schwartz, R.C. 1995 :ix). From the mid 1970's onwards family therapy as a intervention strategy in social work succeeded and expanded, it was extended to encompass client populations from different cultural backgrounds, and special groups e.g. drug additions. These context suggest that family therapy needs to he practiced within the context of a particular culture. The purpose of this study is to explore the Xhosa families perceptions on family therapy and the role of culture in their life style.

In this dissertation, the writer explores and supports the validity of clinical social wor·k practitioners applying planned therapeutic intervention procedures to couples who are in distress. Written in two parts, this paper is esentially a review of selected literature on the efficacy of social work psychotherapv with couples. Couple therapy, which deals with the two individuals per se and not merely with their interaction, enhances the treatment of both partners. Several intervention strategies are noted by the writer, all of which attempt to alter both individual dynamics and that of the couples relationship. The writer has chosen a "fusion model" comprising of the intra and inter-personal intervention strategies. The therapeutic format of choice proposed by the writer favours a time-limited psychodynamic approach which operates through the medium of a combined concurrent-conjoint technique.

Bibliography: pages 68-73. / The family in Western society is increasingly perceived as threatened by a myriad of socio-cultural changes, and statistics suggest that family breakdown is cause for major concern to clinical practitioners working with families. This study attempts to examine the issue of female role transition within the family with a view to understanding the dynamics of conflict and breakdown which are generated by departure from the female role stereotype. A cross-disciplinary review of the literature has sought to place the discussion of case-study material within a broad psycho-social context. The emphasis throughout is on the interplay between the complex macro variables and the intra-psychic functioning of individual clients. Five case histories are used to identify the etiological and diagnostic features which interact within the family as a sub-system. Concluding discussion offers a psychodynamic interpretation of the case material.

The purpose of this study was to examine the impact of brain injury upon the family of the brain-injured patient. Although some research into the psychosocial sequelae following head injury and the direct and indirect effects of severe head-injury upon the family have been conducted, these studies have largely been of a quantitative nature. For this reason, and with a view to expanding upon the existing findings, the present study was qualitative in nature in order to gain an in-depth understanding of relatives' experience of living with and caring for a severely head-injured family member. In addition, ways in which family members coped with the impact of the brain injury were elicited. Participants were caregivers to 11 severely head-injured patients who were representative of a range of socio-economic groupings and racial classifications. Severity of head injury was controlled for and participants were interviewed two or more years after the head injury had occurred. Demographic and injury related data were elicited by means of a questionnaire. Thereafter, data was collected by means of in-depth semi-structured interviews. A number of indices were developed based on a qualitative and descriptive analysis of the data. The study found that the mam source of distress experienced by caregivers related to emotional rather than physical symptomatology. All types of family relationships were profoundly affected by the patient's brain injury, although the caregiver's relationship with the patient appeared most vulnerable. Formal sources of support were considered inadequate and most caregivers relied heavily on emotional support, particularly from an intimate source. Coping responses were dependent upon coping resources available. Families of brain-injured patients who were racially and socio-economically disadvantaged were subjected to additional stress related to the unavailability of services and the randomness with which services that were available were dispensed. Rehabilitation services appeared to be failing to meet the needs of "brain-injured families" (Brooks, 1984) as they concentrated on the patient's physical handicap rather than emotional sequelae of the head injury.