rhr: Assessment of Diverse Family Systems rhl:Handbook of Multicultural Assessment

CHAPTER 12: ASSESSMENT OF DIVERSE FAMILY SYSTEMSDANIEL T. SCIARRA

GEORGE M. SIMON

case extract begins

Elana stared plaintively for a moment at her husband, Curtis, and then turned toward the therapist. : “We were a happy couple as long as we were both foreigners. Now that I am the only foreigner and he is on his home turf, everything has turned sour.”

Curtis and Elana sought couple therapy after she had stumbled upon the fact that he had been having an extramarital affair. This was the third time that Elana had caught Curtis in an affair. On all three occasions, Curtis had ended the affair immediately after Elana discovered it.

Curtis, a native of New York City, had met Elana about 6 six years prior to the crisis that brought them into therapy. They had met in Israel, where Curtis was on a week’s leave from his military assignment in Kuwait. Elana, an Ethiopian Jew, had migrated to Israel, along with her family, when she was a young child. “We caught each other’s eye at a club,” Curtis laughingly explained to the therapist, “because we were the only black people in the place.” The couple had spent an intense week together, and had remained in contact with each other when Curtis returned to his assignment. A few months later, he had been reassigned to a post in Virginia. He invited Elana to join him, and she accepted. The two got an apartment together, and married within a couple of months, got married.

As they told their story to the therapist, both spouses agreed that the ensuing two years had been idyllic. This was the period when, in Elana’s words, they were both “foreigners.” Curtis had found rural Virginia, where they were living, almost as foreign as had Elana, and so, out of necessity, the spouses had developed an intense reliance on each other. Except for

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when Curtis was working, they became nearly inseparable. Happily, they found that they enjoyed each other’s company immensely.

Then came the development that instigated the rapid unraveling of the couple’s tightly wound relationship. Curtis was transferred to a recruiting office not far from the New York City neighborhood where he had grown up, and where most of his family and childhood friends still resided. They spouses secured an apartment in Curtis’s old neighborhood, and Curtis began renewing his old social contacts. As Elana astutely observed, she was now the only “foreigner” in the marriage. Where Curtis had previously thrived upon Elana’s dependence on him, he now began to experience her as “clingy” and “needy.” He began to put distance between himself and his wife, and she began to make ever more exaggerated expressions of dependence on him.

Curtis had his first affair 4 four months after he and Elana had moved to New York. Over the course of the next 2½two and a half years, he had become involved in two more. Each of the affairs had ended with the same dramatic scene, in which Elana confronted Curtis with the evidence she had accumulated, and he, penitently admitting to his transgression, begged her not to end the marriage. The couple’s most recent rendition of this now all-too-familiar scene had been played out two weeks prior to their first meeting with the therapist.

It was now the therapist’s task to decide how to intervene into this troubled marriage.

Family Assessment: A Range of Options

The literature of the field of family therapy makes available to Curtis and Elana’s therapist a considerable array of assessment schemes and related therapeutic protocols which that the therapist could use to make sense of and to intervene into the couple’s functioning. So numerous, in fact, are such schemes and protocols, that several efforts have been made to organize and categorize them.

Minuchin, Lee, and Simon (2006), for example, have divided family therapy models into interventionist and restrained approaches. Interventionist models, as they are defined by these authors, prescribe a relatively high degree of activism on the part of the therapist, aimed at eliminating family dysfunction. Restrained models, on the other hand, seek

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to protect client families from a therapist’s potentially disempowering meddling, by severely restricting the domain of family functioning into which the therapist is allowed to intervene, and/or by prescribing an exaggerated posture of tentativity for the therapist.

In a related effort at categorization, Simon (2003) has attempted to organize family therapy models based on the models’ underlying stances on the following five fundamental philosophical issues: “the relationship between the individual and the group, the proper use of human freedom in relational/ethical decision making, the question of whether humans are capable of doing evil, the relationship between mind and body, and the question of whether primacy in the human domain belongs to being or becoming” (Simon, 2006, p. 334)

Yet another way of categorizing family therapy models can be used to throw into relief the manner in which the models deal with the issues raised by a multicultural perspective. Fraenkel (1995) has proposed that models of family therapy can be categorized as being nomothetic or idiographic in their orientation. Those models are nNomothetic that utilizemodels use concepts of allegedly universal validity to reach normative judgments regarding the relative adaptiveness of a given family’s functioning. Idiographic models, on the other hand, eschew universal descriptive schemes, in favor of viewing each family as a unique entity unto itself. We find Fraenkel’s proposal helpful, and will use a modified version of it to provide an overview of the varying ways in which the major models of family therapy deal with the issue of multicultural assessment. Instead of a simple dichotomous characterization of the models as being either nomothetic or idiographic, we will use a tripartite scheme, depicting models as being nomothetic, idiographic, or a systematic blending of nomothetic and idiographic elements.

Idiographic ModelsPare′é (1995, 1996) provided perhaps the clearest and most concise

statement of an idiographic perspective on family therapy when he proposed that family therapists think of each family as a distinct culture unto itself. Family therapy, Parée′ (1996) asserts, can be thought of as an encounter between two cultures—: the culture that is the client family and the culture that is the therapist.

If each family is a culture unto itself, then any attempt to understand the family using concepts imported from the outside—equivalently, from a foreign culture—constitutes nothing less than an

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exercise in colonialism. Preexisting assessment schemes thus need to be assiduously avoided in clinical practice.:

When informed by the metaphor of a meeting of cultures, I am inclined in my clinical work to take heed of the practices that have been seen to lead to the devastation of indigenous cultures. The metaphor itself entails the hegemonic risks associated with the practice of therapy: the therapist as colonial power (Kearney, Byrne, &and McCarthy, 1989), the therapeutic model as the dogma of a foreign culture, the therapy room as the mission school where religious conversion and cultural assimilation are the undergirding agendas. ( [Parée′, 1996, p. 28)].

The postmodern therapies developed by Harlene Anderson (1997, 2001; Anderson &and Goolishian, 1988), Steve de Shazer (Berg &and de Shazer, 1993; Miller & and de Shazer, 1998, 2000), and Michael White (1991; White and& Epston, 1990) exemplify Pare′é’s idiographic aversion to preexisting assessment schemes. Key concepts of these idiographic models are presented in Table 12.1.

Table 12.1.~NS

Key Concepts of Representative Idiographic ModelsMODEL LITERATURE

REFERENCES REFERE NCES

GOAL OF THERAPY THERAPY

SIGNATURE INTERVENTION INTERV ENTION

Collaborative language systems therapy

Anderson (1997, 2001); Anderson & Goolishian, 1988)

Facilitate the ongoing elaboration of the constellation of meanings that the client family has developed to describe and explain the presenting problem

Questioning based on an attitude of “not- knowing,” i.e.that is, an attitude that no meaning expressed by clients is simple, clear, and easily understandable

Solution-focused therapy

Berg & de Shazer (1993); Miller & de Shazer (1998, 2000)

Help the client family to identify and to amplify exceptions to the presenting problem that are already occurring

Questioning and tasks, designed to help clients identify and amplify exceptions to the presenting problem

Narrative therapy White (1991); White & Epston (1990)

Liberate the client family from the subjugating influence that societal-level

Externalization, i.e. (the depiction of the family as beset by an anthropomorphized

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cultural discourses have on the family’s indigenous meaning- making and wisdom

external enemy, bent on subjugating the family)

Anderson’s collaborative language systems therapy is typical of these models, when it demands that its practitioner enter into each therapeutic encounter with a family with an attitude of “not- knowing.” The language systems therapist does not use an assessment protocol to make sense of the client family’s situation; instead, the therapist listens carefully to the sense that family members themselves are already making of their own situation.

A language systems therapist working with Elana and Curtis would note Elana’s use of the word “foreigner” and Curtis’s use of the word “needy” to make sense of their relational situation. These words would be significant for the therapist, not because they have some relevance to an assessment scheme that the therapist brought into the therapy, but because the words are central to the language the clients themselves are using to assess their own situation.

As conceived in the collaborative language systems approach to therapy, it is the therapist’s task simply to ask questions that invite family members to elaborate further the home-grown constellation of meanings that have evolved within the family to describe and to explain the therapy’s presenting problem. In doing so, the therapist assiduously avoids leading the therapeutic conversation in any given direction, based on some pre-understanding of the clinical situation.:

The language systems therapist attempts to keep the [family’s] conversation fluid by adopting the attitude that no meaning expressed as part of the conversation is simple, clear, and easily understandable. . . . Participating in the [family’s] conversation in this way, the language systems therapist helps keep the conversation tending in the direction of the not-yet-said. ( [Simon, 2003, p. 22)].

The model assumes that, given the inherent evanescence of meaning, a fluid conversation about the presenting problem, tending always toward the not-yet-said, will inevitably evolve to the point where the presenting problem is defined out of existence (in the language of the model, dis-solved).

While the collaborative language systems approach to therapy focuses on a client family’s idiosyncratic meaning- making around

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something that they have defined to be a problem, de Shazer’s[[AU: Add to the References, and insert the date here. ]] solution-focused therapy focuses on the family’s idiosyncratic solutions to the problem. As much as the collaborative language systems therapist does, the solution-focused therapist avoids imposing any kind of pre-understanding on the clinical situation. Thus, like a language systems therapist, a solution-focused therapist would refuse to utilize use any kind of preexisting assessment scheme to inform a therapeutic encounter with Curtis and Elana, choosing instead to useutilize what is indigenous to the couple. However, differently from a language systems therapist, a solution-focused therapist would be relatively disinterested in how the couple is making sense of their situation. Instead, she/ or he would be interested in unearthing what Elana and Curtis are already doing, from time to time, separately and/or collectively, to alleviate, at least a little bit, the state of affairs that they have presented as the problem to be addressed in therapy.

That Curtis and Elana are already enacting such solutions is an article of faith for the solution-focused therapist. At the beginning of therapy, the therapist does not know what they are. True to the non-normative ethos that characterizes all of the idiographic models of family therapy, the solution-focused therapist certainly has no pre-existing notion of what these solutions should be. The therapist restricts him/self or herself to the task of asking Curtis and Elana questions and giving them tasks designed to help them become aware of what they are already doing to contain and to alleviate their presenting problem. Once the couple has identified their idiosyncratic solutions to their presenting problem, the therapist will encourage them to amplify these solutions.

White’s narrative therapy values the indigenous meaning- making and wisdom of families as much as does collaborative language systems therapy and solution-focused therapy. However, it is far less optimistic than are the other two models that a simple therapeutic conversation, focused exclusively on the local culture of a client family, can succeed in bringing a client family’s indigenous wisdom to the fore.

The narrative model is founded on the keen awareness that local conversations, within a family and within the therapy room, take place within the context of broader sociocultural discourses. The model views these broader discourses negatively, seeing them as inevitably working to subjugate and eradicate local meaning- making and wisdom.:

[N]arrative therapy sees group-level phenomena as being inevitably dehumanizing. For narrative therapy, that which is authentically human is always found at the level of the local and the particular. The further one moves from the level of the individual, the more one moves into the domain

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of the impersonal, the coercive, and the dehumanizing. ([Simon, 2003, p. 28)].

It must be noted that narrative therapy’s negative valuation of societal-level cultural discourses is not restricted to the discourses of a given society’s dominant culture. Rather, all cultures, including those that might have minority status within a given society, are seen as ultimately dehumanizing and coercive. Narrative therapists Griffith and Griffith (1994) state this view plainly: “

Authentic expression of personal experience is always fluid, idiosyncratic, and unpredictable. It does not know the bounds imposed by cultural practices. . . . It inevitably takes a stand against some type of cultural practice. . . (1994, (p. 58; , emphasis added).

Avoiding pre-existing assessment schemes, the strategy utilized used by the language systems therapist and the solution-focused therapist to avoid subjugating a client family’s local culture, will not, in the view of the narrative therapist, succeed in purging the therapeutic conversation of the destructive influence of broader sociocultural discourses. The only way that the therapeutic conversation can achieve the liberation of a client family’s local knowledge, which is the goal of all the idiographic therapies, is for the conversation to focus explicitly on the pervasive, corrosive effects of societal-level cultural discourses.

Noting how frequently Elana and Curtis make use of the word “foreigner” to make sense out of their relational difficulties, a narrative therapy working with them would attempt to sensitize them—and to increase her/ or his own sensitivity, as well—to the negative connotations imparted to this word by the various sociocultural discourses in which the therapist, Curtis,, and Elana are immersed. The therapist would have used this strategy no matter what language the couple used to explain their problem. In the view of the narrative therapist, the problems that lead people to seek therapy are almost invariably the result of the impoverishing, subjugating influence that sociocultural discourses have on the language people use to make sense of their life together.

In order to make their subjugation visible to Curtis and Elana, a narrative therapist would utilize use the signature narrative technique of externalization. The therapist would anthropomorphize “foreignness,” depicting the couple as tyrannized by this external enemy, who is bent on destroying their marriage. Utilizing Using an elaborate protocol of therapeutic questions, the therapist would ask the couple to explore the destructive influence that “foreignness” has had on their relationship. Crucially, the therapist would ask Elana and Curtis to detail how they, separately and collectively, have succeeded in keeping “foreignness” from

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damaging their relationship even more than it has. The narrative therapist would anticipate that in response to his/herthis questioning, the couple would move from the mutual blaming in which they are currently engaged, a blaming that serves only to increase the power of “foreignness,” to a pooling of resources in a shared battle against the externalized enemy into which the therapeutic conversation would have transmuted “foreignness.”

In their prizing of local knowledge and in their wariness of becoming mechanisms of cultural domination, the idiographic models of family therapy are thoroughly in sync with the fundamental ethos of the multicultural movement in the mental health disciplines. In their zeal to privilege local conversations and local wisdom, these models have expunged from the therapeutic protocols that they prescribe the whole notion of therapist-driven assessment. So thoroughgoing is these models’ wariness of therapy becoming an exercise in cultural colonialism, that topics which constituteing key components of other multicultural therapeutic approaches—topics such as ethnicity, immigration, acculturation, and racial identity, etc.—are in these models either completely ignored (unless raised by the clients themselves), or, in the case of narrative therapy, seen as part of the problem (therapist-driven, “professional” discourse) rather than part of the solution.

Nomothetic Models Where the idiographic models of family therapy bring client

families’ own assessments of their life- situations to the fore of the therapeutic encounter, the nomothetic models prescribe a therapy process constructed around therapists’ assessments of what is transpiring in families. These therapist-driven assessments utilize use pre-existing conceptual schemes that purport to provide descriptions of family processes that possess near-universal validity.

Before we begin to summarize some of the models that we judge to be nomothetic in their orientation, we must insert a disclaimer. Our categorization of models as nomothetic is based solely on the published literature about these models. We recognize that therapy done can look very different from therapy written about. It is possible, even likely, that many practitioners of the models that we are about to mention include, in their implementation of the models, accommodations to the local and to the particular that are lacking in formal, written renditions of the models. Such accommodations may or may not fit organically into the model that is being utilizedused. If there is an organic fit, then what is being practiced is not a nomothetic therapy, but a therapy with a systematic blending of nomothetic

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and idiographic elements, about which we will have more to say later in this chapter.

All of what are considered the “classic” models of family therapy are unabashedly nomothetic in their conceptualization of the therapeutic process. All identify some aspect of family functioning that is deemed to play a determinative role across cultures in the genesis and/or maintenance of therapy-relevant human problems. The models prescribe ways in which the therapist can assess this putatively crucial aspect of family functioning. The models then go on to detail interventive protocols designed to influence this area of functioning. Key concepts of the nomothetic models that we are about to summarize, both classic and contemporary, are provided in Table 12.2.

Table 12.2.~NS

Key Concepts of Representative Nomothetic ModelsMODEL LITERATURE

REFERENCES REFERENCES

GOAL OF THERAPY THERAPY

SIGNATURE INTERVENTION INTERVENTIO N

Structural family therapy

Minuchin (1974); Minuchin & Fishman (1981)

Adaptively restructure family subsystem boundaries

Enactment, i.e. (direct interaction between family members during the therapy session)

Strategic family therapy

Haley (1987) Adaptively restructure incongruous hierarchies within the family

Assignment of between-session tasks, individually tailored for each client family so as to reduce resistance

Bowen family systems therapy

Bowen (1966); Kerr & Bowen (1988)

Increase family- members’ level of differentiation

Coaching of adult family members to assume a more differentiated posture in their respective families of origin

Emotionally focused therapy

Johnson (2002, 2004)

Access and amplify family- members’ expression of attachment-related emotions

Softening, i.e. (eliciting the experience and expression of “soft,” attachment-related emotions)

Structural family therapy is typical of these classic, nomothetic approaches to family therapy. A structural family therapist working with Elana and Curtis would enter his/ or her first encounter with the couple assuming that their presenting problem is maintained by dysfunctional boundaries within the relational system of which they are

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members. Thus, early in the encounter, the therapist would assess the quality of the boundary between the spouses, and between the spousal subsystem and other social systems with which it interacts (Minuchin, 1974). (We will describe structural family therapy’s conceptualization of family functioning in greater detail later in this chapter.)

A practitioner of strategic family therapy would also bring some well well-defined assumptions into her/histhis first encounter with Curtis and Elana. The model that she/ or he practices is founded on the view that therapy-relevant human problems are maintained by incongruous hierarchies within family systems (Haley, 1987). These are hierarchies that are either the reverse of developmentally appropriate hierarchies (e.g.for example, a child exercising authority over a caregiver), or a hierarchy that exists where none is appropriate (for examplee.g., between a husband a wife). A strategic therapist meeting with Elana and Curtis would focus her/his assessment efforts on detecting the presence of incongruous hierarchies. In the process of doing so, she/ or he would almost certainly take note of the fact that most of the time, Curtis occupies of a one-up position vis-à-visin relation to Elana, and that this situation undergoes a temporary reversal and “correction” of sorts in the aftermath of Elana’s discovery of an affair.

For a practitioner of Bowen family systems therapy, it is people’s lack of differentiation that gives rise to symptomatic expression. Lack of differentiation reveals itself when strong emotions swamp a person’s cognitive functioning, with the result that the person behaves reactively rather than in a calm, deliberative manner (Bowen, 1966; Kerr &and Bowen, 1988). A Bowenian therapist would see in Elana’s emotional displays of neediness and in Curtis’s reactive distancing from his wife evidence that they are both lacking in differentiation. Seeing family-of-origin processes as exercising determinative influence on people’s level of differentiation, the Bowenian therapist would mount an effort to assess what dysfunctionally triangular relational arrangements in Curtis’s and Elana’s respective families of origin had resulted in the lack of differentiation displayed in their dealings with each other.

By and large, the classic models of family therapy do not prescribe the use of formal, structured assessment protocols to elicit the data that they consider central to the therapeutic enterprise. Practitioners of all three of the classic models just referenced rely heavily on their observation of and interaction with client families during the first therapy session in order to construct their assessment of the families. The structural family therapist makes extensive use of the signature technique of enactment for assessment purposes, eliciting direct interactions among family members in the consulting room, which allow the therapist to

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observe the quality of the boundaries between family subsystems, and between the family-as-a-whole and the outside world, represented in the therapeutic situation by the therapist him/self or herself (Minuchin &and Fishman, 1981). While perhaps making some use of enactment, the strategic therapist relies more on questioning to ferret out the incongruous hierarchies that will become the target of his/ or her signature intervention, : the assignment of between-session tasks that are individually tailored for each client family so as to decrease the family’s inevitable resistance to change. The Bowenian therapist observes clients’ in-session behavior, both toward her/self or himself and toward each other, to detect the presence of the emotional reactivity, which, according to the model, provides the best indicator of clients’ degree of differentiation.

Uniquely among the classic family therapy models, Bowen family systems therapy does prescribes the use of a structured assessment protocol, in addition to the therapist’s informal observation of family processes occurring in vivo in the therapeutic setting. In order to elicit and to organize data about the family-of-origin processes that the Bowenian therapist considers so crucial in determining clients’ levels of differentiation, the therapist engages clients in the shared construction of genograms—, diagrams that graphically display relational processes across at least three generations in the families of origin of the adult members of the client family. The Bowenian therapist uses these genograms to guide his/ or her signature intervention, : the coaching of adult members of the client family to assume differentiated, non-reactive postures in relating to key members of their respective families of origin.

WhileAlthough all of the classic models of family therapy are nomothetic, so, too, are many of the models that have been developed more recently. Typical, in this regard, is emotionally focused therapy, an evidence-based treatment for couples presenting relational distress as a focus for treatment (Johnson, 2004). Grounding itself in attachment theory, emotionally focused therapy sees most couple dysfunction as resulting from the intersection of couple members’ maladaptive attachment styles, resulting in self-reinforcing sequences of destructive interaction. The emotionally focused therapist seeks to modify these sequences via her/hisusing his or her signature technique of softening, i.e.: the empathic accessing and amplifying of “soft,” attachment-related emotions that are seen as underlying the “hard,” self-protective emotions that couple members experience and express as they engage in their usual dysfunctional relational dance.

Accessing these softer emotions requires that the therapist assess the attachment styles of clients. While Although paper-and-pencil instruments are available for such assessment, the emotionally focused

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therapist prefers to rely on direct observation of clients’ behavior toward each other and toward him/ or her in the immediacy of the therapeutic encounter in order to construct his/heran assessment of clients’ attachment styles. Such observation of Elana and Curtis would likely lead the emotionally focused therapist to assess that Elana has an anxious attachment style, to which she gives expression in her pursuit of her husband, and that Curtis has an avoidant style, which primes his distancing from Elana.

Emotionally focused therapy, like the classic nomothetic family therapy approaches that came before it, “assumes that we are all children of the same mother” (Johnson, 2002, p. 54). These models assume that, in the most therapeutically relevant aspects of their functioning, all families are essentially the same. All the nomothetic models presume that a therapist skilled in assessing families should be able to do so effectively across a broad range of cultures.

Systematic Nomothetic/-Idiographic Blends

The idiographic models of family therapy are founded on the premise that all families are fundamentally different; the nomothetic models assume that all families are fundamentally the same. This difference in outlook reflects, and has its roots in, a millennia-old quandary within the Western philosophical tradition regarding how best to conceive the relationship between the one and the many (see Simon, 2003). Both the idiographic and the nomothetic models share the strategy of resolving this quandary by associating themselves exclusively with one pole of the One/Manythis polarity.

However, another strategy for resolving the quandary is possible. One can take the position that both the idiographic and the nomothetic models reflect half, and only half, of the clinically useful truth: in the ways that matter to the family therapist, families are both all different and all the same. If one adopts this synthetic position, then what are is needed to ground the therapeutic enterprise are models of treatment that systematically and coherently blend idiographic and nomothetic elements.

One way of achieving this blend has been proposed by Monica McGoldrick and her colleagues (McGoldrick, Giordano, and& Garcia-Preto, 2005). These authors do not call into question the assumption made by all nomothetic models of family therapy, : that there is some

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aspect of family functioning that, across families and across cultures, is pivotally involved in the genesis and/or maintenance of therapy-relevant human difficulties. Accordingly, the authors accept the need for therapists to assess client families in that area of functioning deemed crucial by the model that they are practicing. However, the authors demur from the nomothetic assumption that what constitutes adaptive functioning in this area is the same across cultures. Different cultures provide differing renditions of “normal” family life. Thus, McGoldrick would maintain that assessing boundaries, or hierarchies, or differentiation, or attachment styles in the case of Elana and Curtis must take into account Elana’s Ethiopian Jewish cultural heritage and Curtis’s middle-class African- American cultural heritage, which provide the standards against which judgments of “functional” and “dysfunctional” must be made. The work of Boyd-Franklin (2003) and of Falicov (1998) has amplified and extended McGoldrick’s approach to constructing a systematic blending of nomothetic and idiographic elements in therapeutic models.

While laudable in their attempt to render family assessment sensitive to the particularities of culture, the efforts just referenced can be criticized for overly emphasizing the nomothetic in the systematic nomothetic/-idiographic blending that they have tried to achieve. Although the efforts recognize between-culture differences in what constitutes “normal” family functioning, they gloss over within-culture differences, and so, from an idiographic perspective, they still tend to privilege the universal over the local and particular.

George Gushue (1993; Gushue & and Sciarra, 1995) has proposed a scheme of family assessment that he sees as containing, using the language of this chapter, a more balanced blending of idiographic and nomothetic elements. Gushue accepts the description of between-culture differences in “normal” family functioning offered by scholars like those just referenced. However, calling on models of cultural-identity development (e.g., Atkinson, Morten, and& Sue, 1979), Gushue notes that individuals from a minority culture assume a variety of positions toward their own culture and toward the dominant culture in which they are immersed. Cultural-identity development models assume hold that these positions assume predictable forms, and that these forms evolve in predictable sequences. Thus, individuals, say within a given family, can be compared as to their relative levels of cultural-identity formation. By attending to the family dynamics resulting from the interplay of family members’ varying levels of cultural-identity formation, therapists can construct an assessment of a given client family that is more genuinely attentive to the local and particular than would be possible were the

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assessment based on the assumption that the family- as- a- whole subscribes to the norms prescribed by the family’s ethnic culture.

Practitioners of the postmodern, idiographic models that we described earlier in this chapter would likely judge that Gushue (1993) has been only partially successful in his attempt to increase the idiographic component in the nomothetic/-idiographic blend that he has proposed. Of concern to these practitioners would be Gushue’s unquestioning reliance on developmental thinking in his model. A postmodern perspective would view developmental thinking as nothing more than an artifact of the dominant, Western, positivistic, “professional” cultural discourse. Ironically, in utilizing using the concept of cultural-identity development in his attempt to render family assessment more attuned to the local, Gushue can be viewed as having becoming become an unwitting exponent of the imposition of a therapist-driven, “foreign” cultural discourse on minority families. His model can still be criticized for favoring the nomothetic in its nomothetic/-idiographic blend.

Structural Family Therapy: A Nomothetic/-Idiographic Rendition

We will now propose yet another scheme for systematically blending nomothetic and idiographic elements in the task of assessing families. The This scheme that we will propose has been constructed in much more explicit dialogue with the postmodern, idiographic models of family therapy summarized earlier in this chapter than were the nomothetic/-idiographic blends just referenced. As a result, our scheme is constructed along significantly different lines from these other blends. The nomothetic elements in our blend come from structural family therapy (SFT). The idiographic elements are heavily indebted to the collaborative language systems model of family therapy.

Nomothetic Elements Along with most of the classic models of family therapy,

SFT views the family as a system. Understanding the family as a system entails seeing its members as being so interconnected as to constitute, quite literally, a single, multibodied organism (Minuchin & and Fishman, 1981). Behaviors enacted within the family are seen as being co-created by all the members of the family. As a result of this unity of functioning, change in

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one area of the family is seen as inevitably causing compensation in another.

Over time, every family develops patterns of interaction, along with stories that both justify and explain these patterns (Minuchin, Lee, & Simon et al., 2006). SFT uses a structural frame to make sense of these patterns. Family structure is not something that SFT therapists can directly observe or “discover.” Therapists are simply privy to their observations of family members’ interactions, which SFT brings into the therapy room via through its signature technique of enactment. Upon these observable data, SFT therapists impose a conceptual framework that allows them to organize the complex and often confounding world of family interaction and communication. The major components of this framework are the concepts of subsystems, boundaries, and circular causality (Minuchin, 1974).

Subsystems. It occurs naturally in families that some members unite with others

to perform a certain function or to engage in some shared activity. Such functionally united segments of the family system are what SFT refers to as subsystems. As families develop and change over time, different subsystems come into play and exert more or less influence at various points in the family’s developmental trajectory.

Two adults who join together for the explicit purpose of forming a family create a spousal subsystem. (While this term, canonized by long usage by SFT therapists, implies that the adults are married, and even heterosexual, such, of course, need not be, and frequently is not, the case.) Each adult brings into the relationship a set of values and expectations that must be reconciled if they are to live together with a degree of harmony. In order to achieve this harmony, a set of rules is established, some of which are explicitly negotiated (Jane goes food shopping on Saturday morning, while Dick does the laundry), while others remain implicit (when Dick is in an angry mood, Jane goes out with one of her friends).

Precisely because its members usually carry differing relational expectations, harmony in the spousal subsystem is not easily achieved. Some degree of conflict between the partners is to be expected, and resolution of a given set of conflictual issues is likely to be followed in fairly short order by the emergence of another. As with all else, the spousal subsystem develops patterns for dealing with conflict. It may be dealt with through direct exchange, and so remain contained within the subsystem.

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Alternatively, and less functionally, one or both members of the spousal subsystem may seek allies outside of the subsystem. In another potentially dysfunctional arrangement, the spousal subsystem may stabilize a pattern of detouring away from conflict by turning toward other things and/or people as a distraction. Children, if present in the family, frequently serve as the focus toward which spousal conflict is detoured.

If children do enter the family, whether by birth, adoption, or fostering, a new set of functional demands, focused on child- rearing, is brought to bear on the system, giving rise to a new subsystem, the parental subsystem. In a nuclear family, the parental subsystem is usually composed of the two adults who joined together originally to form the family. The parental subsystem may, however,It may also include many different people—: grandparents, aunts or uncles, an older child, a live-in nanny, or anyone else designated to guard, discipline, and nurture the younger and more vulnerable family members.

In assessing families, SFT therapists pay careful attention to the parental subsystem. What is its constituency? Is anyone included who might not be appropriate (e.g.perhaps a younger, parentified child)? Is anyone excluded who might serve as a resource (perhapse.g. one of the adults)? How is authority exercised by the subsystem? If there are two parents present, is authority in the hands of both, or of just one, to the exclusion of the other? Do the members of the parental subsystem work together as a team in managing and disciplining the children, or is the authority of one member of the subsystem undermined by another member?

When the constituency of the parental and spousal subsystems is identical, it can be expected that problems in the spousal subsystem might reduce the effectiveness of the parental subsystem. Specifically, mismanaged conflict in the spousal subsystem could undermine the effectiveness of the parental subsystem. As noted above, the triangulation of children into spousal conflicts is quite common. For example, one parent might enter into a coalition with a son or daughter against the other parent. The SFT therapist would see such an intergenerational coalition as potentially problematic, as a result of the disempowering of a parent, and the inappropriate empowering of a child, that it produces.

In families with children, the third major subsystem of the family is the sibling subsystem. While children in a family (optimally) live most of their lives under the umbrella of care and management provided by the parental subsystem, they do—or should—have significant interactions among themselves that do not directly involve the adult caregivers. Siblings play together, go to school together, hold secrets together. The sibling

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subsystem is the laboratory in which children can develop the interpersonal skills required for relating to peers throughout the life span. However, it can only serve as such a laboratory only if its integrity is guarded within the family system. One reason that intergenerational coalitions, detouring of spousal conflict toward children, and the parentification of young children, are deemed dysfunctional by SFT therapists is the violation of the integrity of the sibling subsystem that all of these structural arrangements entail.

Boundaries. As implied above, tThe major component of family assessment in

SFT involves is the examination of the relationships among the different subsystems in a family. In making this examination, the SFT therapist relies on the concept of boundaries.

Family subsystems are differentiated by boundaries, invisible barriers that demarcate and define the relationship among the different subsystems (Nichols &and Schwartz, 2006). Moreover, the family system as a whole is differentiated by a boundary that creates both psychological and physical distance between the family and the extra-familial world. For example, a family may have a rule that prohibits the sibling subsystem from having friends stay past 6:00 P.M. on weekdays, since the family eats dinner together and by themselves. This would contrast with a family that has no set time for dinner, and cares little whether there are others in the home while family members are eating.

In SFT, boundaries are assessed along a continuum from rigid to diffuse. A rigid boundary between subsystems produces a disengaged relationship between the members of the respective subsystems, while a diffuse boundary is productive of enmeshed relationships. For example, the SFT therapist would see the overinvolvement of a parent(sone or both parents) in the lives of their children as the result of a diffuse boundary between the parental and sibling subsystems. Other signs of diffuse boundaries in a family system might include a lack of privacy in the home, family members’ finishing one another’s sentences, and parents who are constantly either in school or calling the school to check on their child’s welfare. Signs of a rigid boundary between the parental and sibling subsystems can include a disregard for a child’s difficulty, unreturned telephone calls from school personnel, repeated inability to make meetings concerning the child, and a general inability to foster support when needed.

SFT assumes that problematic families have subsystem boundaries that are too diffuse and/or too rigid. Children who are enmeshed

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with one or both parents receive wonderful care and support, but at the expense of independence and autonomy (Nichols &and Schwartz, 2006). Problems arise when such children are unable to negotiate the demands of the outside world. They might be afraid to go to school, and if they do go to school, they might not have the courage to meet the demands for socialization. Parent-child enmeshment also entails negative impacts for the spousal subsystem, allowing little time and opportunity for the spouses to be alone with each other. The likely result is a non-fulfilling spousal relationship.

In contrast to families with diffuse boundaries, families with rigid boundaries have members who are independent of, yet isolated from, one another. On the positive side, children from disengaged families learn to be resourceful and not to shy away from tasks that require perseverance and mastery. On the negative side, such children will not have experienced the warmth, nurturance, and affection so prevalent in enmeshed families.

Both disengagement and enmeshment can, and frequently do, co-exist within the same family system. For example, one parent might be enmeshed with the sibling subsystem, while the other is disengaged. Father might be enmeshed with his daughter and disengaged from his son. Mother might be overinvolved in her job and underinvolved at home. Whatever the various constellations, SFT relies on the concept of boundaries to assess the overall degree of enmeshment and disengagement among the various subsystems and their individual members.

Circular causalityCausality. The concept of circular causality is central to systems thinking and

to the assessment process in SFT. In opposition to a linear understanding of behavior (A causes B, which causes C), which searches for explanations in the past, circular causality views behavior within a system as being maintained in the present, by repetitive, circular interactional loops. The linear understanding of A causing B causing C is thus replaced by the understanding of A causing B, which, in turn, causes A.

A system regulates itself through circular causality. Consider the simple example of a thermostat used to heat and cool a room. The thermostat instigates heating if the room temperature drops below a set point, and it cuts off heating if the temperature rises above another set point. Through this feedback loop, the thermostat maintains the temperature in the room within a constant range.

When applied to families, the concept of circular causality produces the view that a family member’s behavior is both caused by and

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causes the other members’ behavior. From the perspective of SFT, it is never a question of “who started it” or “who is to blame,” since all family members are assumed to be co-responsible for maintaining any and all patterned behaviors enacted within the family.

A simple example of circular causality might be found in a spousal subsystem that is organized into the well-known pattern of distance-and-pursue. The pursuer pushes for closeness, while the distancer pulls back. The pursuer feels more of a need for connection and pursues harder. The distancer now feels even more need for “space” and distances even more. A more elaborate example involves a punitive father and his acting-out son. The son’s acting out causes the father to be punitive, which in turn elicits further acting out on the son’s part. Mother intervenes by coddling her son, since she cannot stand seeing him cry. Father feels undermined and punishes the son even more.

Idiographic Elements As summarized above, SFT has well-defined notions of how

it is that family systems malfunction. The presence of excessively rigid and/or diffuse boundaries between subsystems, frequently linked to the mismanagement of conflict in the spousal subsystem, is deemed to constitute dysfunctionality within the family. Dysfunctional structural arrangements are assumed to be maintained in the here and now, via through multiply linked and nested interactional loops of circular causality. Family assessment in SFT boils down to a search for the presence of rigid and/or diffuse subsystem boundaries within the client family. Both clinical experience (see, for example, Minuchin, Nichols, &and Lee, 2007), and outcome research (see, for example, Szapocznik &and Williams, 2000), suggest that therapy based on this assessment scheme is effective with families within a broad range of cultural contexts.

However, therapy, even when it is effective, can still be colonizing and impositional. And it must be admitted that, left unchecked, the nomothetic elements in SFT place the model at risk for fitting any family that crosses its path onto the Procrustean bed of its assessment scheme, running roughshod, in the process, over whatever is idiosyncratic to the family.

To reduce this risk, we have incorporated some idiographic elements into the SFT assessment scheme. These elements are intended to provide checks and balances against the universalizing tendency inherent in SFT’s nomothetic outlook. As we will now describe, these elements increase SFT’s sensitivity to the local and particular by providing strict

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criteria regarding when it is and is not appropriate to assess a family, and by prescribing how the results of assessment should be communicated to a family.

To Assess or Not to Assess . We have noted that fFamily dysfunctionality, in the view of SFT, is

associated with “excessive” rigidity and/or diffuseness in a family’s subsystem boundaries. But what constitutes “excessive”?” Those who subscribe to the intellectual/-clinical tradition instigated by Monica McGoldrick would answer that a family’s ethnicity is the crucial determinant of what constitutes “normal” and “excessive” in this matter of the permeability of subsystem boundaries. We have already observed that this approach to norming can be criticized for still privileging the universal/-nomothetic over the local/-idiographic, as a result of its lack of attentiveness to salient within-culture differences.

Inspired by Harlene Anderson’s collaborative language systems model of therapy, which we mentioned earlier in this chapter, we propose that it is the client family itself that must set the standard against which the relative functionality of its subsystem boundaries should be judged. It is the family that should make the determination that its boundaries have become excessively rigid and/or diffuse.

We consider that a family communicates such a determination when it defines into existence a problem that it judges merits therapeutic attention. Following the collaborative language systems model, we assume that “problems”s do not have any kind of objective existence. Like everything else in the human world, a “problem ” only exists only when it is consensually defined into existence by members of a system. A behavior, feeling, or thought is only a “problem” only if some members of the system in which the behavior, feeling, or thought occurs define it to be problematic. Thinking in this way, Anderson and Goolishian (1988) see a family’s defining into existence of a therapy-meriting “problem” as an “alarmed objection” by the family—, the family’s way of signaling that it has determined that there is something is amiss within the system.

As we have just noted, ifIf a family with a “problem” consults with an SFT therapist, that therapist will bring to the encounter several pre-formed ideas of where to look within the family for the malfunction whose existence the family is signaling via by its definition of a “problem.” The therapist assumes that by defining a “problem” into existence, the family is signaling that its subsystem boundaries have become excessively rigid and/or diffuse, according to the family’s own idiosyncratic standards.

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The therapist will thus apply SFT’s assessment scheme to ferret out the enmeshment and/or disengagement, whose presence the family itself has signaled by its generation of a “problem.”

The nomothetic elements in the SFT assessment scheme tell therapists where to look within a family for dysfunction. However, in the perspective that we are presenting here, it is the family itself that signals whether or not a therapist should be looking for dysfunction in the first place. The SFT assessment scheme is radically dependent for its activation on a family’s voluntary presentation of itself for treatment, around a presenting issue that the family itself has determined to be problematic. Thus, we view the SFT assessment scheme to be an intrinsically clinical instrument. We do not believe that the scheme should be used to assess and to categorize families outside of the therapeutic context. Any such extra-therapeutic use runs an excessive risk of turning into an exercise in cultural colonialism.

Moreover, the mere presentation of a family for treatment is not sufficient to justify the activation of the SFT assessment scheme. Before engaging in assessment, the therapist must assiduously determine whether or not the family’s presentation for treatment is genuinely voluntary, and whether or not the “problem” presented as a focus for treatment has genuinely been defined into existence by the family itself. Poor families, and families whose members belong to ethnic minority groups, are notoriously susceptible to having their inner world judged and defined by outsiders (Minuchin, Colapinto, & and Minuchin, 1998; Minuchin, Lee, & Simon et al., 2006). Outside agents, like child welfare workers, family court judges, probation officers, and school personnel, frequently refer these families to treatment to deal with issues that the agents, not the families themselves, have defined to be problematic. Any treatment focused on such “presenting problems” necessarily will be an exercise in social control, not in genuine therapy.

Thus, before embarking on the task of assessment, it is incumbent on the therapist to join with a client family sufficiently to allow its real “customership” for therapy to be revealed. If it turns out that the family has presented itself for therapy under duress, the therapist can offer his/ or her services to help the family remove itself from the supervision of the outside agent(s) who has pushed the family into therapy. In such circumstances, the therapist functions as a culture broker, rather than as a therapist, properly so called. He/ or she helps the family gain clarity regarding that aspect of its functioning that has run the family afoul of societal powers that be. Without either canonizing the standards being employed by these powers, or negatively judging the family’s own idiosyncratic standards, the therapist portrays the family’s predicament as

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resulting from an inadequacy of fit between the family’s local culture and the dominant culture in which it is immersed: “You are caught between two cultural worlds, and an either/-or solution is not viable” (cf.see Simon, 1993). The therapist encourages the family to find alternatives in its repertoire that will assuage the concerns of the outside agents, while still preserving the family’s sense of identity. He/ or she provides support as the family engages in this search for a better fit with the dominant culture. However, the therapist assiduously avoids assessing the family’s structure.

It is our experience that many families that find themselves in this predicament welcome an offer by the therapist to function as a neutral, non-judgmental culture broker. Experiencing the therapist as benign and empathic, some families even go on to volunteer, after a period of time has elapsed, that they do, in fact, have some problem or other, different from the one that has occasioned the mandate into treatment, that has been concerning them and that they would like to make the focus of treatment. If such a presentation of a genuinely self-defined problem is forthcoming, only then, and only then, should the therapist begin to assess the family utilizing using the SFT scheme. Otherwise, the therapist should restrict her/self or himself to helping the family maneuver itself out of the intrusive control being exercised by outside agents.

Communicating Assessment to the Client Family

. Much of what is written about SFT focuses on the model’s conceptualization of family dysfunction. While Whereas it cannot be denied that this conceptualization exerts a powerful influence over the therapeutic process prescribed by SFT, that process is equally influenced by two assumptions about families rarely highlighted in the literature about SFT: the assumption of competence, and the assumption of uniqueness (Simon, 1995).

SFT’s assumption of competence is the assumption that each and every client family brings to the therapeutic encounter sufficient resources to remediate whatever is amiss in the family’s structure (Minuchin, 1974; Minuchin and& Fishman, 1981; Minuchin and& Nichols, 1993; Simon, 1995). The assumption of uniqueness is the assumption that, “whatever characteristics it may share with other families, each family is fundamentally unique” (Simon, 1995, p. 20; see, also, Minuchin and& Nichols, 1993). It is the assumption of uniqueness that makes SFT ripe for being cast into the kind of nomothetic/-idiographic blend that we are presenting here.

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These assumptions exert a powerful influence over SFT’s view of the general goal of therapeutic intervention. Specifically, the assumptions, operating in tandem, lead the SFT therapist to see her/ or his interventive role in therapy to be to activate what is already there in the client family, rather than to supply what is missing.

The SFT therapist’s desire to position him/himself or herself as an activator of a client family’s latent, idiosyncratic resources exerts a determinative influence on how the therapist executes the task of communicating assessment results to the family. Such communication needs to occur in a way that will orient the family toward its own reservoir of resources, rather than toward the therapist as a potential expert provider of “answers” or “healing.”

To accomplish such communication, we advocate that the therapist utilize use another element drawn from the idiographic collaborative language systems model of therapy. We noted earlier in the chapter the language systems therapist’s signature stance of keen attentiveness to the idiosyncratic language used by clients to make sense of their own situation. It is our view that the SFT therapist should adopt this same stance when he/she goes about the task of communicating the results of assessment to families.

Were the therapist to communicate assessment results utilizing using the technical language that we have employed in this chapter in our description of the SFT assessment scheme—the language of systems, subsystems, boundaries, enmeshment, and disengagement—the therapist would almost certainly maneuver him/himself or herself into precisely the “expert” position that he/ or she wants so much to avoid. The journey from assuming such a position to engaging in therapeutic colonialism is an unfortunately all-too-brief one.

Instead, it is our view that the therapist should attend carefully to the client family’s own idiosyncratic language, searching that language for stories, images, and metaphors that refer, in ways that are already meaningful to the family, to those aspects of the family’s functioning about which the therapist wants to talk as he/ or she shares with the family the results of his/herthe assessment. If it receives the results of the assessment cast in its own “native” language, the client family will be less likely to respond to the assessment by concluding that it needs to import some kind of “foreign” knowledge or expertise in order to resolve its presenting problem. The family is more likely to see itself, as the SFT therapist does, : as competent to crystallize its own home-grown alternatives to the dysfunctional components of its structure.

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Case Illustration We will conclude this exposition of our SFT-informed,

blended nomothetic/-idiographic assessment scheme by describing briefly how it was utilized used in the treatment of Curtis and Elana.

case extract begins

As we described above, tThe first task for the therapist dictated by our scheme is to decide whether to assess or not to assess. The crucial determinant used by the therapist uses to make this decision is whether or not the family presenting itself for treatment is doing so voluntarily, around a self-defined problem.

Both the content and the tenor of the therapist’s initial telephone conversation with Curtis strongly suggested to the therapist that this was, indeed, a couple presenting itself voluntarily for treatment. During the conversation, Curtis expressed what sounded like sincere regret for having had yet another extramarital affair, and real concern that this might have been the straw that had broken the back of the marriage. He described both himself and Elana as anxious to begin a therapy that would help them save their threatened marriage.

Early in the first session, Elana confirmed the voluntary status of her participation in therapy. She reported that she had spoken with no one other than Curtis about his affair, and that her decision to enter couple therapy was entirely her own. Meanwhile, Curtis’s behavior during the opening moments of the session did nothing to alter the therapist’s sense that he was genuinely desirous of a therapy aimed at delivering his marriage from the dangerous straits in which it was floundering.

Convinced that the couple system before him was presenting itself voluntarily for treatment around a problem that it itself had defined into existence, the therapist decided that it was appropriate to embark upon a structural assessment of the system. At the first opportunity, about a third of the way through the first session, he elicited an enactment between Curtis and Elana. The therapist asked the spouses to talk with each other about how they thought they were doing as a couple in the aftermath of Curtis’s most resent affair.

As the therapist watched the enactment, he was struck by two characteristics of the interaction between Curtis and Elana that he was observing. First of all, he noted Elana’s relentless pursuit of information from Curtis, information that Curtis just as relentlessly refused to provide. Secondly, he noted the halting nature of the interaction, which was filled

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with embarrassed pauses and averted glances on the part of both spouses.

To test whether these structural characteristics were tied to the particular subject matter of the first enactment, the therapist elicited a second one, focused on the more mundane content of the couple’s division of household responsibilities. Around this very different subject matter, Curtis and Elana interacted in exactly the same way that they had around the hot-button issue of Curtis’s affair. When the interactional pattern repeated itself in a third enactment, focused on how the couple relates to members of Curtis’s family, the therapist felt it reasonable to conclude that the pursue-distance dynamic that he had observed in all three enactments was a stable structural element in this couple system. True to SFT’s systemic thinking, the therapist assumed that this dynamic was maintained by circular causality, with Elana’s pursuit of Curtis eliciting and maintaining his withdrawal, and Curtis’s withdrawal eliciting and maintaining Elana’s pursuit.

As impressed as the therapist was by the ubiquity of Elana and Curtis’s pursue-distance dynamic, he was equally, if not more, impressed by how anxious the couple was to exit the dynamic once it had begun. With each halt and uncomfortable silence in the conversation, of which there were many, the spouses attempted to disengage from each other. As did their interaction with each other, so, too, these exits from interaction assumed an unvarying pattern in all three enactments. When the conversation between them lagged, Elana would become pensive, apparently involved in an internal dialogue with her thoughts and feelings. Curtis, on the other hand, would attempt to engage the therapist in light, jocular banter. The therapist was struck by how easily conversation came to Curtis when the therapist made himself available to interact with him. Gone were the embarrassed pauses that peppered Curtis’s attempts to talk with his wife. Replacing these was a smooth, genuinely engaging conversational style. When the therapist asked Elana if this was the way that Curtis talked with people, she replied sadly, “With everybody but me.”

As the first session was nearing its end, the therapist felt that he had gleaned sufficient evidence from his experience of how Elana and Curtis had interacted with each other and with him to construct an initial map of this client system’s structure. The therapist assessed that the external boundary around this spousal subsystem was excessively diffuse. Curtis clearly interacted more easily with the therapist than he did with his wife, and this pattern appeared to be isomorphic with the way he interacted with friends, members of his family of origin, and, alas, with his lovers. Curtis’s enmeshment with people outside the marriage was recursively linked to disengagement between him and Elana. What engagement there was

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between the spouses had become organized into a pursue-distance complementarity, which, far from succeeding in increasing the involvement between the two of them, had actually served to increase their disengagement. More disengagement between the spouses led to more enmeshment between Curtis and people outside the marriage, which led, in turn, to more disengagement in the marriage.

The therapist closed the first session by communicating his structural assessment to Elana and Curtis. As described above, hHe endeavored to do so using elements of the couple’s own language that seemed to refer to the structural features that the therapist wished to talk about. The therapist judged that in their frequent use of the words “foreigner,” “ home turf,” and “needy, ” Curtis and Elana were already referring to their pursue-distance dynamic, and to the enmeshment and disengagement to which it was recursively linked. Thus, he employed this language as he shared with them his view of their current dysfunctional structure, and of the therapeutic work they would need to do to rectify it:

As you both already seem to sense, you have become foreigners to each other since your move from Virginia to Curtis’s home turf. You both seem to want to get closer, but right now, every attempt you make fails. Your eagerness to be close to Curtis, Elana, comes across to him as neediness. He’s not sure that he can meet your needs, and he backs away. Curtis, it is easy for you to back away, because, after all, you are on your home turf. But your backing away only increases Elana’s eagerness, and she winds up looking even needier to you. Curtis, you need to retrieve what you did to successfully meet Elana’s needs when you were not on your home turf, and find a way to do those things again now that you are. Elana, you need to retrieve the less panicked ways that you used to show your eagerness for Curtis when you were in Virginia, and you need to give those ways a chance to work now, even though you’re on his home turf. You both need to help each other rebuild the sense that you had early in your marriage that, ultimately, your relationship is, for both of you, the real “home turf.”

Conclusion One way to think about multiculturalism is as an attempt to

discern a fitting relationship between the one and the many, between the universal and the particular. The idiographic models of family therapy champion that aspect of the human spirit which is to be found only at the level of the local and the particular. The nomothetic models highlight those elements that are universal in the human spirit. The models that seek to

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achieve a systematic blending of nomothetic and idiographic elements see the essence of genuinely human accomplishment in the creation of a dynamic balance between the universal and the particular, the one and the many.

We subscribe to this latter ethos. The SFT-informed, blended nomothetic/ -idiographic assessment scheme that we have presented in this chapter is based on our belief that it is valuable and clinically useful to think of families as being, all at the same time, both different and the same. We have presented our scheme in the hope that it will spur others to devise blended nomothetic/-idiographic assessment schemes that are both the same as and different from our own.

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