Systemic family therapy in adult psychiatry: a review of 50 families

Article Abstract:

While family therapy has been shown to be successful in treating the psychiatric problems of children and teenagers, the approach has not been used extensively in the adult population. Thus, the role of family therapy for adult patients is still not clear. At a newly established family therapy clinic, the first 50 families to attend, who met certain criteria, were included in a study to assess such issues as the types of patients and the nature of their problems, aspects of the therapeutic process and its structure, and outcome of family therapy. The motivation for the establishment of the clinic was twofold: first, most of the patients had problems that involved their families, and second, there was a long waiting list for these patients for individual psychotherapy services. The focus of the therapeutic technique involved in all cases was upon the underlying organization of the family system rather than upon resolution of particular symptoms. Of the patients who initially sought therapy (as opposed to their family members), most had a neurotic disorder such as obsessions, depression, or anxiety. In addition, a large percentage (40 patients) had a history of previous psychiatric treatment. Within the families, the primary structural problems could be divided into four types: separation and individuation (difficulties living apart from the family), typifying 30 families; marital problems, affecting eight families; a family structural problem, such as poor differentiation of roles, in four families; and unresolved grief, in seven. Problems with the course of therapy most often involved failure to attend sessions or complete treatment. In the opinion of the rating team used in the study, two-thirds of the fifty patients improved by the end of the sessions, and half of the families were functioning better. Fourteen of the patients signed on for further individual or group therapy. The authors believe that the results encountered here are encouraging, and suggest that family therapy might be even more successful if used with patients without a long history of psychiatric problems. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Evaluation, Mentally ill persons, Mentally ill, Structural-strategic family psychotherapy

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Child psychiatry in developing countries

Article Abstract:

Children under the age of 15 years of age constitute between 40 percent and 50 percent of the populations of developing countries, but the field of child psychiatry in these countries has significantly advanced only during the past 20 years. Psychiatrists trained outside these countries are subject to cultural differences, making it difficult for them to understand local developmental and child-rearing practices. This has contributed to the slow advancement of child psychiatry in developing nations. Nevertheless, there are common areas of interest across cultures. For instance, cross-cultural studies looking at both developed and developing countries have found that the rates of behavior problems among school children are similar. Symptoms or behavior which cause one to seek help, however, may be subject to cross-cultural variation, as seen by the increased identification and treatment of learning disorders with the expansion of educational services. Given that the rates of psychiatric disorder in children are likely to be similar across cultures, attention must be given to the factors which influence the identification and treatment of these children. Factors to be considered include organic factors such as malnutrition, and age, sex, and urban versus rural setting must be considered as well. Family factors and child-rearing practices may play a role, sociocultural factors such as attitudes toward and perceptions of mental illness may be important, and services, clinical strategies, and interventions must be looked at. Research methods suitable for use in developing countries must be developed as well. Child psychiatry in developing countries is established as an important field and its practice can be exciting, challenging, and a great influence on social policy concerning children worldwide. (Consumer Summary produced by Reliance Medical Information, Inc.)

International aspects, Developing countries, Growth, Child psychiatric services, Child psychiatry

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