“…The present study was conducted in a setting that was theoretically affected by group analytic (Bion, 1961; Foulkes, 1984; Yalom, 1995) and systemic principles (Flaskas, 2002). The individual with a substance misuse problem and his or her family are seen as suffering individuals trapped in the traumatic experience of addiction.…”
Section: Cultural and Theoretical Considerationsmentioning
Addiction treatment centers often fail to involve families in treatment. The aim of the present study was to explore the challenges that Greek mental health professionals encounter in their work with parents of drug and alcohol abusers. A qualitative study design was adopted, and five focus group discussions were conducted with 27 drug and alcohol professionals. The thematic analysis of their accounts revealed the key difficulties that professionals encounter in their collaboration with parents that included parental lack of involvement or over-engagement in treatment, unrealistic expectations, ambivalence or opposition to change, ethical dilemmas, and alliance issues, as well as collaboration challenges among therapists. Findings highlight the challenges of a family approach in the treatment of addiction, and underscore the value of clinical supervision in addition to specialized training, to help professionals work on their anxiety, anger, guilt, prejudices, and deception, when engaging parents in the treatment of their addicted child.
“…The present study was conducted in a setting that was theoretically affected by group analytic (Bion, 1961; Foulkes, 1984; Yalom, 1995) and systemic principles (Flaskas, 2002). The individual with a substance misuse problem and his or her family are seen as suffering individuals trapped in the traumatic experience of addiction.…”
Section: Cultural and Theoretical Considerationsmentioning
Addiction treatment centers often fail to involve families in treatment. The aim of the present study was to explore the challenges that Greek mental health professionals encounter in their work with parents of drug and alcohol abusers. A qualitative study design was adopted, and five focus group discussions were conducted with 27 drug and alcohol professionals. The thematic analysis of their accounts revealed the key difficulties that professionals encounter in their collaboration with parents that included parental lack of involvement or over-engagement in treatment, unrealistic expectations, ambivalence or opposition to change, ethical dilemmas, and alliance issues, as well as collaboration challenges among therapists. Findings highlight the challenges of a family approach in the treatment of addiction, and underscore the value of clinical supervision in addition to specialized training, to help professionals work on their anxiety, anger, guilt, prejudices, and deception, when engaging parents in the treatment of their addicted child.
“…If we think of mentalization as belonging to this space of overlap and shared therapeutic concerns between the different orientations then – from a clinical if not a political perspective – the oppositional framing of issues of similarity and difference in the discussion of mentalization loses much of its momentum (I shall discuss the political dimension later). Writing in a somewhat related context, Carmel Flaskas () described the clinical situation well:To think of border crossing as occurring in a space between the frameworks and their relationship to the lived experience of practice challenges any polarizing of a lens of similarity versus a lens of difference … it is quite possible to use both the lens of similarity and the lens of difference, and the choice to highlight one lens over the other is often made contextually. (p. 225)In this article I consider some contextual elements that might determine Asen and Fonagy's particular framing of MBT‐F.…”
Section: Mentalization Therapeutic Border Crossing and The ‘Space Bementioning
In this article I explore the relationship between systemic psychotherapy and the model of mentalization‐based therapeutic interventions for families (MBT‐F) presented by Eia Asen and Peter Fonagy. I consider two important contextual elements in MBT‐F; firstly, the influence of the empiricist tradition in which it is anchored and secondly, the political context of this work. Both elements need disentangling from theoretical and clinical concerns to facilitate greater clarity in debates about mentalization and in wider therapeutic discourse. In essence, I conclude that dialogue between systemic and mentalization perspectives can extend well beyond the empiricist framing of MBT‐F in directions that are more broadly consistent with systemic concerns and interests, not least of which is the ongoing challenge to engage ‘harder to reach’ families in innovative systemic psychotherapy.
Practitioner points
A focus on mentalization draws us towards the common ground between the different therapies and their shared challenges.
Thinking about mentalization has the potential to enhance the systemic practitioner's engagement with ‘harder to reach families’.
Thinking systemically has much to offer the mentalization debate.
Creative dialogue between systemic and mentalization perspectives can take many pathways beyond the empiricist framing of the MBT‐F model.
“…On reading their paper together with the response by Flaskas (2002), I found myself wondering what the families being written about might think of the arguments on either side. Should families be made aware of the behind-the-scenes differences that pervade the therapeutic field?…”
Section: Bridging the Gap Between Psychoanalytic And Systemic Approachesmentioning
The context for this paper is the ongoing systemic/psychoanalytic debate. It offers an alternative perspective to the recent contribution by Brodie and Wright (2002), in which they are concerned to underscore difference between the two therapeutic approaches. Here it is argued that the relationship is a great deal more complex than Brodie and Wright's analysis might suggest. Attention is focused on significant areas of commonality, in particular the impact of social constructionist thinking across the two therapies as well as current developments in technique. A case is made for the consolidation of generic space where there is opportunity for cross-fertilization and for integrative and combined systemic/psychoanalytic approaches to be nurtured and developed where appropriate. Case vignettes are used to highlight different aspects of the generic component in child and family therapy and to underline the need for bridge-building between these key therapeutic approaches in the field.
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