Increasingly therapists are called upon to serve as consultants to health care organizations.The consultant is expected to assess the contribution a family systems therapy perspective can make. Among the areas considered are: the family as a health care agency; the place of direct family therapy treatment in health care; protection of the family at risk; the development of appropriate training programs; the place of family therapy in general health policy and in biomedical research. Special features of the health care enterprise as it relates to paradigmatic change are noted as well.
This survey reports the results of a national survey of training programs in family therapy. Two hundred and forty-five programs responded to the survey questionnaire providing data for the development of a master list of training programs and a general assessment of the nature and magnitude of training efforts in the field. The survey included programs housed in diverse institutional settings. The data indicate the extent of growth and the increasing formalization of professional training in family therapy. A classification system is proposed for distinguishing among the major types of facilities providing family therapy training. Programs are compared in terms of the type, duration, and intensity of the training offered and the number of students enrolled.
The Collaborative Family model integrates the advances of the last fifty years in family therapy, behavioral medicine, and biomedicine, building them into an effective, team-based, health care delivery system. The collaborative team is a seamless blend of biologically oriented professionals in a working relationship with psychosocially oriented professionals. As a working group they appreciate that their most important allies are the patient and the patient's family. Together they work as partners in prevention and cost effective treatment.
A. Block, AID.". . . this paper is not an attack on medical science but a demonstration of an inevitable fact: that mere purposive rationality unaided by such phenomena as art, religion, dream, and the like, is necessarily pathogenic and destructive of life; and that its virulence springs specifically from the circumstance that life depends upon interlocking circuits of contingency, while consciousness can only see such short arcs of such circuits as human purpose may direct."Gregory Bateson (4, p. 146) This article originated in an effort to develop a model for relating two classes of events: illness events and family-systems events.The first focus of the article was on the coevolution of disease pattern and family pattern. This led to a reconsideration of the concept of context, as well as what is meant by the term "family." Borrowing from others, who will be cited below, this exploration ultimately led to a consideration of a construct: the problem-generated or problem-defined system. This construct subsumes family and all other elements that are involved in maintaining or disequilibrating the patterns under consideration-a disease pattern or family pattern in the present instance.The main concern of this article is to present the coevolutionary perspective: how an entity and its context evolve together, shape and stabilize each other. Throughout, medical and psychiatric conditions are used as case examples; we will consider a wide variety of such conditions: the abdominal pain syndrome in children, postpartum depression, cervical cancer, nonorganic paralyses in children, among others. The systemic perspective of the article should make clear that in none of these instances are we talking about the cause or etiology of any of these syndromes.
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