The Integrated Use of Individual and Family Psychotherapy

Abstract

For almost thirty years after the development of family therapy, the concurrent use of family and individual psychotherapy was seen as incompatible by leading proponents of each modality. Although recently the literature has revealed an increased willingness to utilize family and individual therapies concurrently, the decision for or against any such combination has been left largely to the intuition or bias of the individual clinician. This paper suggests the concurrent use of family and individual psychotherapies when disturbances of family structure and interaction co-exist with, reinforce, and are maintained by largely ego- syntonic internalized psychopathology (that is, the character defences of individual family members). It provides a rationale for integrating the concurrent therapies, and uses clinical examples to illustrate how each can potentiate the other. There is a discussion of indications and contraindications for the integrated use of concurrent family and individual therapy. From their attempts to apply these principles, the authors conclude that the experience for the family, the individual and the therapists is that the selective and integrated use of concurrent family and individual therapies can achieve more than can either therapy alone--the whole is greater than the sum of the parts.

Family Assessment Measure (FAM) and Process Model of Family Functioning

“…Instead, basic family processes are considered with a clear acknowledgement that a variety of factors (whether intra-psychic or situational) may influence these processes. Thus, the Process Model encourages formulation at both the intra-psychic and system levels (Steinhauer and Tisdall, 1984). The Process Model differs from its predecessor (Family Categories Schema) and the McMaster Model in three significant ways.…”

In Defence of a Modern Medical Model: Purism and Eclecticism in Family Therapy*

“…These include Ackerman, Howells, Kramer, Wynne, Bowen, Framo, and Boszormenyi-Nagy. In their paper on 'The Integrated Use of Individual and Family Psychotherapy', Steinhauer and Tisdall (1984) predicated their theoretical overlap on the concept of separation and individuation. Family members who fail to individuate are incapable of intimacy.…”

Clinical Applications of the Process Model of Family Functioning*

“…It is for this reason that the Process Model attempts to begin integrating individual and family theories. It provides a therapeutic rationale for the selective use of individual, family and combined therapies (18,19).…”

“…At the same time, attempts to deal with their pathology purely at a structural or systems level often prove insufficient, since even if members acknowledge their respective contributions (which is infrequent) or even if during therapy they can temporarily suppress pathological interaction patterns, they usually lack the impulse control to change their behaviour in a significant or lasting way. For such families, concurrent family and individual therapy can often achieve more together than either can separately (18,25).…”